Direct Clinics Inc

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

DIRECT CLINICS INC

Practice address

8980 S Federal Hwy Ste 100B
Port St Lucie, FL 34952-3482

Phone

(888) 484-2466

NPI assigned

Feb 15, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Wallace De Rothsman

Title

Ceo

Phone

(650) 797-8441

Specialties & licenses 3

Addresses

Other names 1

• DIRECT CLINICS Doing business as

Locations

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

{
    "created_epoch": "1644883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649203200000",
    "number": "1689329922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 NE 164TH ST STE 296",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331603703",
            "telephone_number": "888-484-2466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8980 S FEDERAL HWY STE 100B",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349523482",
            "telephone_number": "888-484-2466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIRECT CLINICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-15",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A",
        "authorized_official_last_name": "DE ROTHSMAN",
        "authorized_official_first_name": "WALLACE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "650-797-8441",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DIRECT CLINICS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Adolescent and Children Mental Health Clinic/Center in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Adolescent and Children Mental Health Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; 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.