NPIMap

Organization Active NPI

Living Free Therapy Services LLC

  • Mental Health Counselor
  • Fort Walton Beach, FL
National Provider Identifier
1649623448
Registry record updated Dec 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH13396 Issued in FL
Legal business name
LIVING FREE THERAPY SERVICES LLC
Practice address
217 Miracle Strip Pkwy SE
Fort Walton Beach, FL 32548
Phone
(833) 611-3733
Fax
(888) 959-6012
NPI assigned
Jul 15, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2017

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

Authorized official

Name
Mrs. Melissa Nelson, LMHCNPI 1407234834
Title
Owner/Therapist
Phone
(850) 296-9047

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
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X MH13396 FL Primary

Addresses

Primary practice location

217 Miracle Strip Pkwy SE
Fort Walton Beach, FL 32548

Mailing address

P.O. Box 1004
Mary Esther, FL 32569
Phone (833) 611-3733

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1468540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512691200000",
    "number": "1649623448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1004",
            "city": "MARY ESTHER",
            "state": "FL",
            "postal_code": "32569",
            "telephone_number": "833-611-3733",
            "fax_number": "888-959-6013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 MIRACLE STRIP PKWY SE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "32548",
            "telephone_number": "833-611-3733",
            "fax_number": "888-959-6012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING FREE THERAPY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-15",
        "last_updated": "2017-12-08",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "850-296-9047",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH13396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.