Papillon Health and Wellness LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

PAPILLON HEALTH AND WELLNESS LLC

Practice address

643 SW Granadeer St
Port Saint Lucie, FL 34983-8772

Phone

(561) 412-9281

NPI assigned

Sep 22, 2022

Organization subpart

No

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

Authorized official

Name

Bonnie RussoNPI 1366922288

Title

Owner/Provider

Phone

(561) 412-9281

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 2

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

• Bonnie Russo, LCSW, QS

  • Mental Health Counselor
  • Port Saint Lucie, FL
  • NPI 1366922288

  Clinical

  Medicare reassignment Care Compare group NPD Authorized official
• Lauren Leigh Odell, LMFT

  • Marriage & Family Therapist
  • Fort Pierce, FL
  • NPI 1497011514
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1663804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663804800000",
    "number": "1639892854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "643 SW GRANADEER ST",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349838772",
            "telephone_number": "561-412-9281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "643 SW GRANADEER ST",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349838772",
            "telephone_number": "561-412-9281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAPILLON HEALTH AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-22",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A",
        "authorized_official_last_name": "RUSSO",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "561-412-9281"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mark Jon Pamer, D.O.
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• Claudio Pantoja Ramgeet, RCSWI
• Paradise Group Home Care LLC
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• Ashia Parker
• Darnel Parker

• Clinical Social Worker in Port Saint Lucie, FL
• Providers in Port Saint Lucie, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.