Baybrooke Center LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH13006 Issued in FL

Legal business name

BAYBROOKE CENTER LLC

Practice address

4995 49TH St N
St Petersburg, FL 33709

Phone

(727) 827-7890

Fax

(727) 279-4631

NPI assigned

Jan 2, 2015

Organization subpart

No

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

Authorized official

Name

Ms. Ronda Sue Miller, LMHC

Title

President

Phone

(727) 827-7890

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1420156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544486400000",
    "number": "1457749145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4995 49TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "33709",
            "telephone_number": "727-827-7890",
            "fax_number": "727-279-4631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4995 49TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "33709",
            "telephone_number": "727-827-7890",
            "fax_number": "727-279-4631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYBROOKE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-02",
        "last_updated": "2018-12-11",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "RONDA",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-827-7890",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH13006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in St Petersburg, FL
• Providers in St Petersburg, 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 Dec 11, 2018; 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.