Elite Life Counseling

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

ELITE LIFE COUNSELING

Practice address

695 A1A N Unit 113
Ponte Vedra Beach, FL 32082-2755

Phone

(904) 515-5090

NPI assigned

Apr 1, 2019

Organization subpart

No

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

Authorized official

Name

Brittany Ledford

Title

Therapist

Phone

(904) 515-5090

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554076800000",
    "number": "1578025490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3948 3RD ST S STE 507",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322505847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "695 A1A N UNIT 113",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320822755",
            "telephone_number": "904-515-5090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE LIFE COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-01",
        "last_updated": "2019-04-01",
        "status": "A",
        "authorized_official_last_name": "LEDFORD",
        "authorized_official_first_name": "BRITTANY",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "904-515-5090"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.