Cool Spirit Professional Association

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

MH 12642 Issued in FL

Legal business name

COOL SPIRIT PROFESSIONAL ASSOCIATION

Practice address

300 George Bush Blvd
Delray Beach, FL 33444-4036

Phone

(561) 859-0950

NPI assigned

Feb 12, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Matthew Fanali Jr., L.M.H.C., C.A.P.

Title

Clinical Director

Phone

(561) 596-1602

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1455235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455667200000",
    "number": "1679932081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 SNUG HARBOR DR.",
            "address_2": "A9",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "33435",
            "telephone_number": "561-596-1602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 GEORGE BUSH BLVD",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334444036",
            "telephone_number": "561-859-0950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOL SPIRIT PROFESSIONAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-12",
        "last_updated": "2016-02-17",
        "status": "A",
        "authorized_official_last_name": "FANALI",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "561-596-1602",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "L.M.H.C., C.A.P."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "FL",
            "license": "MH 12642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Conviva Medical Center Management LLC
• Conviva Medical Center Management LLC
• Erin Conway
• Juliet Cooke
• Sandra Lynn Cooklin, OTR/L
• Brandon Coons
• Andrew Cooper
• Gary Alan Cooperstein, D.O.
• Ashley Coote, LMHC
• Georgia S Copulos

• Substance Abuse Rehabilitation Facility in Delray Beach, FL
• Providers in Delray Beach, FL by specialty
• Substance Abuse Rehabilitation Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2016; 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.