Southwest Florida Sports Counseling LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

SOUTHWEST FLORIDA SPORTS COUNSELING LLC

Doing business as

SWFL Sports Counseling

Practice address

621 Cape Coral Pkwy E Ste 19C
Cape Coral, FL 33904-8548

Phone

(941) 677-8002

NPI assigned

Jan 13, 2022

Last updated

Jan 13, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kimberly A Rogers, LMHCNPI 1477855476

Title

Owner

Phone

(941) 677-8002

Specialties & licenses 1

Addresses

Other names 1

• SWFL Sports Counseling Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kimberly A Rogers, LMHC

  • Mental Health Counselor
  • Cape Coral, FL
  • NPI 1477855476
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1642032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642032000000",
    "number": "1457002164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 CAPE CORAL PKWY E STE 19C",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339048548",
            "telephone_number": "941-677-8002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 CAPE CORAL PKWY E STE 19C",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339048548",
            "telephone_number": "941-677-8002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST FLORIDA SPORTS COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-13",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-677-8002",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SWFL Sports Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Amelda W. Span, M.S. EDUCATION

• Mental Health Counselor in Cape Coral, FL
• Providers in Cape Coral, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.