Therapy Tree to Life LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

THERAPY TREE TO LIFE LLC

Practice address

217 Miracle Strip Pkwy SE
Fort Walton Beach, FL 32548-5819

Phone

(850) 992-7753

NPI assigned

Jan 4, 2025

Last updated

Jan 4, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Pascha AveryNPI 1649828435

Title

Owner

Phone

(404) 397-4567

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, and the practitioner matching its NPPES authorized official.

• Pascha Avery, LMHC

  • Mental Health Counselor
  • Hurlburt Field, FL
  • NPI 1649828435
  NPD Authorized official

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

{
    "created_epoch": "1735948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735948800000",
    "number": "1518776574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9471 PARKER PLACE DR",
            "city": "NAVARRE",
            "state": "FL",
            "postal_code": "325662864",
            "telephone_number": "404-397-4567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 MIRACLE STRIP PKWY SE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325485819",
            "telephone_number": "850-992-7753"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9471 Parker Place Dr",
            "address_purpose": "LOCATION",
            "city": "Navarre",
            "state": "FL",
            "postal_code": "325662864",
            "country_code": "US",
            "telephone_number": "404-397-4567",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THERAPY TREE TO LIFE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-04",
        "last_updated": "2025-01-04",
        "certification_date": "2025-01-04",
        "status": "A",
        "authorized_official_last_name": "AVERY",
        "authorized_official_first_name": "PASCHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-397-4567"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason W Thackeray, M.D.
• Lam Thai
• The Spine Institute at Orthopaedic Associates PL
• The Village ABA, LLC
• Theodore I Macey MD PA
• Vanessa Cloutier Thibodeaux, MD
• Thomas C. Church M.D., PA
• Thomas H Moraczewski MD
• Thomas J. Manski, M.D., P.a.
• Brian Timothy Thomas

• Mental Health Counselor in Fort Walton Beach, FL
• Providers in Fort Walton Beach, 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 Jan 4, 2025; 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.