Counseling Center of Brevard, LLC

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

MH 13192 Issued in FL

Legal business name

COUNSELING CENTER OF BREVARD, LLC

Practice address

1413 S Patrick Dr
Suite 1
Indian Harbour Beach, FL 32937-4373

Phone

(321) 432-9282

Fax

(321) 777-5964

NPI assigned

May 1, 2017

Organization subpart

No

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

Authorized official

Name

Mrs. Karin Painter, MS

Title

LMHC

Phone

(321) 543-1185

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1493596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493596800000",
    "number": "1659806313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1413 S. PATRICK DR.",
            "address_2": "SUITE 1",
            "city": "INDIAN HARBOUR BEACH",
            "state": "FL",
            "postal_code": "32937",
            "telephone_number": "321-432-9282",
            "fax_number": "321-777-5964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1413 S PATRICK DR",
            "address_2": "SUITE 1",
            "city": "INDIAN HARBOUR BEACH",
            "state": "FL",
            "postal_code": "329374373",
            "telephone_number": "321-432-9282",
            "fax_number": "321-777-5964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNSELING CENTER OF BREVARD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-01",
        "last_updated": "2017-05-01",
        "status": "A",
        "authorized_official_last_name": "PAINTER",
        "authorized_official_first_name": "KARIN",
        "authorized_official_title_or_position": "LMHC",
        "authorized_official_telephone_number": "321-543-1185",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "FL",
            "license": "MH 13192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018561500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Claire Stagg DDS PA
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• Patricia Erika Cornelius, COTA/L
• Matthew A Cramer
• Cynthia L. Eames, LMHC
• Daryl E. Askeland D.M.D.,P.a.
• Nadiya Davis, FNP
• Katherine Decker, MPT

• Point of Service in Indian Harbour Beach, FL
• Providers in Indian Harbour Beach, FL by specialty
• Point of Service in Florida

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