NPIMap

Organization Active NPI

Bespoke Psychotherapy Services, P.a.

  • Adult Mental Health Clinic/Center
  • Fort Myers, FL
National Provider Identifier
1659046852
Registry record updated Dec 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
BESPOKE PSYCHOTHERAPY SERVICES, P.A.
Practice address
17595 S Tamiami TRL Ste 210
Fort Myers, FL 33908-4889
Phone
(239) 310-2110
Fax
(239) 310-2111
NPI assigned
Aug 10, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2022

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

Authorized official

Name
Mr. Todd A. Battles, LMHCNPI 1285243816
Title
Owner
Phone
(239) 310-2110

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

17595 S Tamiami TRL Ste 210
Fort Myers, FL 33908-4889

Mailing address

Todd a. Battles, LMHC
17595 South Tamiami Trail, Suite 210
Fort Myers, FL 33908-4884
Phone (239) 310-2110

National Provider Directory

National Provider Directory

Locations

17595 S Tamiami Trl
Ste 210
Fort Myers, FL 33908
Phone (239) 310-2110

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1628553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670544000000",
    "number": "1659046852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "TODD A. BATTLES, LMHC",
            "address_2": "17595 SOUTH TAMIAMI TRAIL, SUITE 210",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339084884",
            "telephone_number": "239-310-2110",
            "fax_number": "239-310-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17595 S TAMIAMI TRL STE 210",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339084889",
            "telephone_number": "239-310-2110",
            "fax_number": "239-310-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BESPOKE PSYCHOTHERAPY SERVICES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-10",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A",
        "authorized_official_last_name": "BATTLES",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-310-2110",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2022; 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.