Individual provider Active NPI

James R Soda

  • Mental Health Counselor
  • Hobe Sound, FL
National Provider Identifier
1609382225
Registry record updated Dec 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH15004 Issued in FL
Practice address
11181 SE Federal Hwy
Hobe Sound, FL 33455-5128
Phone
(303) 550-9982
Fax
(303) 550-9982
NPI assigned
Dec 19, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X ACD.0000453 CO
Professional Counselor 101YP2500X LPC.0012446 CO
Mental Health Counselor 101YM0800X MH15004 FL Primary

Addresses

Primary practice location

11181 SE Federal Hwy
Hobe Sound, FL 33455-5128

Mailing address

239 E River Park Dr
Jupiter, FL 33477-9307
Phone (303) 489-0420

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ACD.0000453COMDAddiction (Substance Use Disorder) Counselor
MH15004FLMDMental Health Counselor
LPC.0012446COMDProfessional Counselor

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1513641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513641600000",
    "number": "1609382225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 E RIVER PARK DR",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334779307",
            "telephone_number": "303-489-0420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11181 SE FEDERAL HWY",
            "city": "HOBE SOUND",
            "state": "FL",
            "postal_code": "334555128",
            "telephone_number": "303-550-9982",
            "fax_number": "303-550-9982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SODA",
        "first_name": "JAMES",
        "middle_name": "R",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-19",
        "last_updated": "2017-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "ACD.0000453",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC.0012446",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH15004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hobe Sound, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2017; 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.