NPIMap

Organization Active NPI

Seaside Counseling, LLC

  • Clinical Social Worker
  • New Smyrna Beach, FL
National Provider Identifier
1639420722
Registry record updated Oct 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW9595 Issued in FL
Legal business name
SEASIDE COUNSELING, LLC
Practice address
800 E 11TH Ave
New Smyrna Beach, FL 32169-3304
Phone
(386) 690-9585
NPI assigned
Sep 28, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2012

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

Authorized official

Name
Tracy S Floyd, LCSWNPI 1699939264
Title
Owner/Manager
Phone
(386) 690-9585

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X SW9595 FL Primary

Addresses

Primary practice location

800 E 11TH Ave
New Smyrna Beach, FL 32169-3304

Mailing address

PO Box 1031
New Smyrna Beach, FL 32170-1031
Phone (386) 690-9585

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1348790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349049600000",
    "number": "1639420722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1031",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321701031",
            "telephone_number": "386-690-9585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E 11TH AVE",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321693304",
            "telephone_number": "386-690-9585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEASIDE COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-28",
        "last_updated": "2012-10-01",
        "status": "A",
        "authorized_official_last_name": "FLOYD",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "386-690-9585",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW9595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Smyrna Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2012; 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.