NPIMap

Organization Active NPI

Free at Heart Online Therapy Licensed Clinical Social Worker PC

  • Clinical Social Worker
  • Fullerton, CA
National Provider Identifier
1669049581
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
FREE AT HEART ONLINE THERAPY LICENSED CLINICAL SOCIAL WORKER PC
Practice address
140 E Commonwealth Ave Ste 208
Fullerton, CA 92832-1905
Phone
(530) 591-5915
NPI assigned
Jun 9, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2024

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

Authorized official

Name
Mr. Michael Courter, LCSWNPI 1497891634
Title
Ceo
Phone
(530) 591-5915

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

140 E Commonwealth Ave Ste 208
Fullerton, CA 92832-1905

Mailing address

1237 Mocking Bird LN
Eclectic, AL 36024-6368
Phone (530) 591-5915

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL free-heart.org Direct
Direct Messaging Address mc@free-heart.org Direct

National Provider Directory

National Provider Directory

Locations

140 E Commonwealth Ave
Ste 208
Fullerton, CA 92832
Phone (530) 591-5915

Practitioners & affiliated clinicians

Practitioners 11

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": "1623196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707696000000",
    "number": "1669049581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1237 MOCKING BIRD LN",
            "city": "ECLECTIC",
            "state": "AL",
            "postal_code": "360246368",
            "telephone_number": "530-591-5915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 E COMMONWEALTH AVE STE 208",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928321905",
            "telephone_number": "530-591-5915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREE AT HEART ONLINE THERAPY LICENSED CLINICAL SOCIAL WORKER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-09",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A",
        "authorized_official_last_name": "COURTER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "530-591-5915",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "free-heart.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "140 E Commonwealth Ave Ste 208",
            "city": "Fullerton",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928321905",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mc@free-heart.org",
            "affiliation": "N",
            "endpointDescription": "Email Adress",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "140 E Commonwealth Ave Ste 208",
            "city": "Fullerton",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928321905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; 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.