Individual provider Active NPI

Caryn Ivy Immler, LMHC

  • Mental Health Counselor
  • Boca Raton, FL
National Provider Identifier
1467652099
Registry record updated Jul 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH 8838 Issued in FL
Practice address
2672 NW 28TH Ter
Boca Raton, FL 33434-6028
Phone
(561) 212-2974
NPI assigned
Jul 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH 8838 FL Primary

Addresses

Primary practice location

2672 NW 28TH Ter
Boca Raton, FL 33434-6028

Mailing address

2672 NW 28TH Ter
Boca Raton, FL 33434-6028
Phone (561) 212-2974

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MH 8838FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1185062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185062400000",
    "number": "1467652099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2672 NW 28TH TER",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334346028",
            "telephone_number": "561-212-2974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2672 NW 28TH TER",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334346028",
            "telephone_number": "561-212-2974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMMLER",
        "first_name": "CARYN",
        "middle_name": "IVY",
        "name_prefix": "Ms.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-22",
        "last_updated": "2007-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 8838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2007; 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.