Innovative Counseling Experience

Primary specialty

CounselorTaxonomy code 101Y00000X

Legal business name

INNOVATIVE COUNSELING EXPERIENCE

Practice address

11097 Hearth Rd
Spring Hill, FL 34608-3704

Phone

(352) 684-7665

Fax

(352) 684-7665

NPI assigned

Aug 24, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Fernanda Mango, MA

Title

President

Phone

(352) 666-6744

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1578670501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3448 PLAZA AVE",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346083945",
            "telephone_number": "352-684-7665",
            "fax_number": "352-684-7665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11097 HEARTH RD",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346083704",
            "telephone_number": "352-684-7665",
            "fax_number": "352-684-7665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE COUNSELING EXPERIENCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MANGO",
        "authorized_official_first_name": "FERNANDA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-666-6744",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "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 Aug 22, 2020; 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.