Modern Reality

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

MODERN REALITY

Practice address

200 Knuth Rd Ste 101
Boynton Beach, FL 33436-4635

Phone

(561) 402-9655

NPI assigned

Jun 18, 2019

Organization subpart

No

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

Authorized official

Name

Casey BranniganNPI 1619544038

Title

Owner

Phone

(561) 402-9655

Specialties & licenses 1

Addresses

Electronic endpoints 1

Practitioners 1

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

• Casey Brannigan, LMHC

  • Mental Health Counselor
  • Boynton Beach, FL
  • NPI 1619544038
  NPD Authorized official

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

{
    "created_epoch": "1560816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560816000000",
    "number": "1528628856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 KNUTH RD STE 101",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334364635",
            "telephone_number": "561-402-9655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 KNUTH RD STE 101",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334364635",
            "telephone_number": "561-402-9655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN REALITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-18",
        "last_updated": "2019-06-18",
        "status": "A",
        "authorized_official_last_name": "BRANNIGAN",
        "authorized_official_first_name": "CASEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-402-9655"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.simplepractice.com",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "address_1": "200 Knuth Rd Ste 101",
            "city": "Boynton Beach",
            "state": "FL",
            "country_code": "US",
            "postal_code": "334364635",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Adolescent and Children Mental Health Clinic/Center in Boynton Beach, FL
• Providers in Boynton Beach, FL by specialty
• Adolescent and Children Mental Health Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2019; 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.