Mercy Road Christian Counseling Centers, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

MERCY ROAD CHRISTIAN COUNSELING CENTERS, LLC

Practice address

530 Dog Track Rd
Longwood, FL 32750-6546

Phone

(407) 937-0440

NPI assigned

Dec 5, 2024

Last updated

Dec 5, 2024By 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

Michael Radka

Title

Ceo

Phone

(407) 937-0440

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1733356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733356800000",
    "number": "1609682574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 DOG TRACK RD",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327506546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 DOG TRACK RD",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327506546",
            "telephone_number": "407-937-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY ROAD CHRISTIAN COUNSELING CENTERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-05",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A",
        "authorized_official_last_name": "RADKA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "407-937-0440"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Young and Associates
• Lauren Mackenzie Melton, BCBA
• Franciny Mena
• Katharine W. Mendoza, MSW, LCSW
• Rosanell Merced, DC
• Morgan Meredith, LMHC
• MF Longwood LLC (Longwood Health and Rehabilitation Center)
• Mark Miceli, MSW
• Michael E. Hempfield, DC, Fiama, LLC
• Michelle Butler

• Mental Health Clinic/Center (Including Community Mental Health Center) in Longwood, FL
• Providers in Longwood, FL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; 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.