Brevard Counseling Associates

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH13868 Issued in FL

Legal business name

BREVARD COUNSELING ASSOCIATES

Practice address

1589 S Wickham Rd
Melbourne, FL 32904-3540

Phone

(321) 328-8664

Fax

(321) 325-1949

NPI assigned

Jan 9, 2016

Last updated

Jan 9, 2016By 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

Jerry A Summerfield, LMHC

Title

Owner

Phone

(321) 328-8664

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1452297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452297600000",
    "number": "1548626393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1589 S WICKHAM RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329043540",
            "telephone_number": "321-328-8664",
            "fax_number": "321-325-1949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1589 S WICKHAM RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329043540",
            "telephone_number": "321-328-8664",
            "fax_number": "321-325-1949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREVARD COUNSELING ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-09",
        "last_updated": "2016-01-09",
        "status": "A",
        "authorized_official_last_name": "SUMMERFIELD",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-328-8664",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "FL",
            "license": "MH13868",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "MH13868",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH13868",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "FL",
            "license": "MH13868",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Brevard Clinical Research Center, Inc.
• Brevard Community Health Services, Inc.
• Brevard County Dialysis, LLC (Renal Care Group Brevard)
• Brevard County Orthopedic & Spine Associates LLC
• Brevard Emergency Services
• Brevard Eye Center
• Brevard Eye Center

• Mental Health Counselor in Melbourne, FL
• Providers in Melbourne, 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 9, 2016; 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.