NPIMap

Organization Active NPI

Alyssa Buchanan, LLC

Doing business as Skylight Counseling Services

  • Clinical Social Worker
  • West Melbourne, FL
National Provider Identifier
1487194817
Registry record updated Jan 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW12384 Issued in FL
Legal business name
ALYSSA BUCHANAN, LLC
Doing business as
Skylight Counseling Services
Practice address
630 S Wickham Rd Ste 107
West Melbourne, FL 32904-1429
Phone
(321) 608-0604
Fax
(321) 608-0604
NPI assigned
Mar 4, 2017
Last updated
Jan 12, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2022

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

Authorized official

Name
Alyssa Buchanan, LCSWNPI 1487088449
Title
Owner
Phone
(321) 608-0604

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU
Mental Health Counselor 101YM0800X NU
Clinical Social Worker 1041C0700X SW12384 FL Primary

Addresses

Primary practice location

630 S Wickham Rd Ste 107
West Melbourne, FL 32904-1429

Mailing address

630 S Wickham Rd Ste 107
West Melbourne, FL 32904-1429
Phone (321) 608-0604

Other identifiers 1

IdentifierTypeStateIssuer
014820300MedicaidFL

Other names 1

  • Skylight Counseling Services Doing business as

National Provider Directory

National Provider Directory

Locations

700 N Wickham Rd
Ste 206
Melbourne, FL 32935
Phone (321) 608-0604

630 S Wickham Rd
Ste 107
West Melbourne, FL 32904
Phone (321) 608-0604

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1488585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641945600000",
    "number": "1487194817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 S WICKHAM RD STE 107",
            "city": "WEST MELBOURNE",
            "state": "FL",
            "postal_code": "329041429",
            "telephone_number": "321-608-0604",
            "fax_number": "321-608-0604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 S WICKHAM RD STE 107",
            "city": "WEST MELBOURNE",
            "state": "FL",
            "postal_code": "329041429",
            "telephone_number": "321-608-0604",
            "fax_number": "321-608-0604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALYSSA BUCHANAN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-04",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A",
        "authorized_official_last_name": "BUCHANAN",
        "authorized_official_first_name": "ALYSSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-608-0604",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW12384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014820300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Skylight Counseling Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Skylight Counseling Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2022; 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.