Gulf Coast Rehabilitation Services, Inc.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

MH11189 Issued in FL

Legal business name

GULF COAST REHABILITATION SERVICES, INC.

Practice address

3825 Henderson Blvd
Suite 405
Tampa, FL 33629-5037

Phone

(877) 957-3422

Fax

(877) 957-3422

NPI assigned

Sep 28, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Joshua Elliott Shannon, SAP,CAP,CEAP,LMHCNPI 1518261973

Title

Ceo

Phone

(877) 957-3422

Specialties & licenses 11

Addresses

Locations

Practitioners 1

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

• Joshua Elliott Shannon, PHD, LMHC, CRC, CEAP

  • Mental Health Counselor
  • Tampa, FL
  • NPI 1518261973

  Counselor

  NPD Authorized official

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

{
    "created_epoch": "1285632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395187200000",
    "number": "1447569264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13798",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336813798",
            "telephone_number": "877-957-3422",
            "fax_number": "877-957-3422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3825 HENDERSON BLVD",
            "address_2": "SUITE 405",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336295037",
            "telephone_number": "877-957-3422",
            "fax_number": "877-957-3422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF COAST REHABILITATION SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-28",
        "last_updated": "2014-03-19",
        "status": "A",
        "authorized_official_last_name": "SHANNON",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "ELLIOTT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "877-957-3422",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "SAP,CAP,CEAP,LMHC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "FL",
            "license": "MH11189",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "5525",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "5552",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH11189",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "FL",
            "license": "SW7468",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "FL",
            "license": "MH11189",
            "primary": true
        },
        {
            "code": "102L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychoanalyst",
            "state": "FL",
            "license": "SW7468",
            "primary": false
        },
        {
            "code": "102L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychoanalyst",
            "state": "FL",
            "license": "MH11189",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "SW7468",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": "FL",
            "license": "SW7468",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW7468",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Tampa, FL
• Professional Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2014; 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.