NPIMap

Organization Active NPI

Theracounsel, Inc.

  • Clinical Social Worker
  • Fort Lauderdale, FL
National Provider Identifier
1457460339
Registry record updated Sep 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
THERACOUNSEL, INC.
Practice address
2808 NE 22ND St
Ft Lauderdale, FL 33305-2804
Phone
(954) 564-9460
Fax
(954) 564-1371
NPI assigned
Aug 30, 2006
Last updated
Sep 22, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2011

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

Authorized official

Name
Prof. Sherri Issa, LCSWNPI 1730164914
Title
President
Phone
(954) 564-9460

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
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

2808 NE 22ND St
Ft Lauderdale, FL 33305-2804

Mailing address

2808 NE 22ND St
Ft Lauderdale, FL 33305-2804
Phone (954) 564-9460

Other identifiers 1

IdentifierTypeStateIssuer
K4369OtherFLMEDICARE PART B

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040628000603 FL Part B Supplier - Clinic/Group Practice 0143206466 Receives reassigned benefits from 20 practitioners
Practice locations: Deerfield Beach, FL; Fort Lauderdale, FL; Ft Lauderdale, FL; Hollywood, FL; Lauderhill, FL; Pembroke Park, FL; Sunrise, FL; West Palm Beach, FL…

National Provider Directory

National Provider Directory
Tax ID family
Theracounsel Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4546 N Federal Hwy
Ft Lauderdale, FL 33308
Phone (954) 328-6163

4546 N Federal Hwy
Ste 210
Ft Lauderdale, FL 33308

2144 Lincoln St
Hollywood, FL 33020
Phone (954) 922-1995

2040 N Dixie Hwy
Ste 229
Wilton Manors, FL 33305
Phone (954) 478-0770

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316649600000",
    "number": "1457460339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2808 NE 22ND ST",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333052804",
            "telephone_number": "954-564-9460",
            "fax_number": "954-564-1371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2808 NE 22ND ST",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333052804",
            "telephone_number": "954-564-9460",
            "fax_number": "954-564-1371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERACOUNSEL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2011-09-22",
        "status": "A",
        "authorized_official_last_name": "ISSA",
        "authorized_official_first_name": "SHERRI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-564-9460",
        "authorized_official_name_prefix": "Prof.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "K4369",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2011; 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.