Island Equanimity LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

ISLAND EQUANIMITY LLC

Practice address

317 Riveredge Blvd.
Suite 104
Cocoa, FL 32922

Phone

(321) 795-2752

NPI assigned

Jul 25, 2024

Organization subpart

No

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

Authorized official

Name

Christine White, LCSWNPI 1255912838

Title

LCSW/ Owner

Phone

(321) 795-2752

Specialties & licenses 1

Addresses

Practitioners 1

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

• Christine Elaine White, LCSW

  • Clinical Social Worker
  • Merritt Island, FL
  • NPI 1255912838
  NPD Authorized official

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

{
    "created_epoch": "1721865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721865600000",
    "number": "1467280818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 RIVEREDGE BLVD.",
            "address_2": "SUITE 104",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "32922",
            "telephone_number": "321-795-2752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 RIVEREDGE BLVD.",
            "address_2": "SUITE 104",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "32922",
            "telephone_number": "321-795-2752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND EQUANIMITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-25",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-17",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "LCSW/ OWNER",
        "authorized_official_telephone_number": "321-795-2752",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jennifer Marie Jackson, L.M.T.
• Jean Jacobson, MA, RMHCI

• Adult Mental Health Clinic/Center in Cocoa, FL
• Providers in Cocoa, FL by specialty
• Adult Mental Health Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.