Space Coast Center for Sexual Health LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

SPACE COAST CENTER FOR SEXUAL HEALTH LLC

Practice address

1314 Port Malabar Blvd NE
Palm Bay, FL 32905-5238

Phone

(321) 412-1301

NPI assigned

Feb 2, 2023

Last updated

Feb 2, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jessica Singh, LCSWNPI 1104289917

Title

Executive Director

Phone

(321) 412-1301

Specialties & licenses 1

Addresses

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.

• Jessica Singh

  • Clinical Social Worker
  • Palm Bay, FL
  • NPI 1104289917
  NPD Authorized official

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

{
    "created_epoch": "1675296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675296000000",
    "number": "1659077576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 PORT MALABAR BLVD NE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329055238",
            "telephone_number": "321-412-1301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 PORT MALABAR BLVD NE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329055238",
            "telephone_number": "321-412-1301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPACE COAST CENTER FOR SEXUAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-02",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A",
        "authorized_official_last_name": "SINGH",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "321-412-1301",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Palm Bay, FL
• Providers in Palm Bay, 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 Feb 2, 2023; 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.