Cooperative Coaching Concepts

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MT2587 Issued in FL

Legal business name

COOPERATIVE COACHING CONCEPTS

Practice address

3607 Alt 19 Ste B
Palm Harbor, FL 34683-1412

Phone

(727) 505-2155

Fax

(727) 796-0158

NPI assigned

Aug 18, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Matthew Howe Welch, LMFT

Title

Owner

Phone

(727) 505-2155

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1503014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503014400000",
    "number": "1619493970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "686 ROANOKE ST",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "346988421",
            "telephone_number": "727-505-2155",
            "fax_number": "727-796-0158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3607 ALT 19 STE B",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346831412",
            "telephone_number": "727-505-2155",
            "fax_number": "727-796-0158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOPERATIVE COACHING CONCEPTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-18",
        "last_updated": "2017-08-18",
        "status": "A",
        "authorized_official_last_name": "WELCH",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "HOWE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-505-2155",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT2587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015005342",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Palm Harbor, FL
• Providers in Palm Harbor, FL by specialty
• Marriage & Family Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.