Organization Active NPI

Counseling Associates of Lake Mary, Inc

  • Mental Health Counselor
  • Stuart, FL
National Provider Identifier
1679044242
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
COUNSELING ASSOCIATES OF LAKE MARY, INC
Practice address
8340 SW Sundance Cir
Stuart, FL 34997-4847
Phone
(304) 699-2256
Fax
(844) 617-1549
NPI assigned
Dec 7, 2018
Last updated
Apr 8, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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

Authorized official

Name
Jodi Whitten MillerNPI 1912959222
Title
President
Phone
(304) 609-2256

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 Counselor 101YM0800X NU Primary

Addresses

Primary practice location

8340 SW Sundance Cir
Stuart, FL 34997-4847

Mailing address

8340 SW Sundance Cir
Stuart, FL 34997-4847
Phone (304) 699-2256

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250428001025 FL Part B Supplier - Clinic/Group Practice 8527584127 Receives reassigned benefits from 1 practitioner
Practice locations: Stuart, FL

National Provider Directory

National Provider Directory

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": "1544140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744070400000",
    "number": "1679044242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8340 SW SUNDANCE CIR",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349974847",
            "telephone_number": "304-699-2256",
            "fax_number": "844-617-1549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8340 SW SUNDANCE CIR",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349974847",
            "telephone_number": "304-699-2256",
            "fax_number": "844-617-1549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNSELING ASSOCIATES OF LAKE MARY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-07",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "JODI",
        "authorized_official_middle_name": "WHITTEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-609-2256"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.