Organization Active NPI

Optimum Healing Circle, LLC

  • Mental Health Counselor
  • Fort Myers, FL
National Provider Identifier
1447074356
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
OPTIMUM HEALING CIRCLE, LLC
Practice address
2180 W First St Ste 200B
Fort Myers, FL 33901-3217
Phone
(239) 387-5008
Fax
(239) 387-5938
NPI assigned
Nov 8, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Shantel Chapman, LMHCNPI 1205570645
Title
Manager
Phone
(239) 387-5008

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

2180 W First St Ste 200B
Fort Myers, FL 33901-3217

Mailing address

3026 Royal Palm Ave
Fort Myers, FL 33901-7335
Phone (239) 287-5008

National Provider Directory

National Provider Directory

Locations

2180 W First St
Ste 200B
Fort Myers, FL 33901
Phone (239) 387-5008

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1731024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731024000000",
    "number": "1447074356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3026 ROYAL PALM AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339017335",
            "telephone_number": "239-287-5008",
            "fax_number": "239-387-5938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2180 W FIRST ST STE 200B",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339013217",
            "telephone_number": "239-387-5008",
            "fax_number": "239-387-5938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM HEALING CIRCLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-08",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A",
        "authorized_official_last_name": "CHAPMAN",
        "authorized_official_first_name": "SHANTEL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "239-387-5008",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.