NPIMap

Organization Active NPI

Advance Bariatric Counseling

  • Clinical Social Worker
  • Debary, FL
National Provider Identifier
1710539192
Registry record updated Nov 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
ADVANCE BARIATRIC COUNSELING
Practice address
239 Florida Willow Ave
Debary, FL 32713-4865
Phone
(407) 564-3459
Fax
(321) 296-6847
NPI assigned
Jul 15, 2019
Last updated
Nov 1, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2023

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

Authorized official

Name
Ashlyn Douglass-Barnes, LCSWNPI 1134544851
Title
LCSW/Owner
Phone
(407) 564-3459

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
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

239 Florida Willow Ave
Debary, FL 32713-4865

Mailing address

239 Florida Willow Ave
Debary, FL 32713-4865
Phone (850) 545-0648

Other practice location 1

531 Versailles Dr Ste 100
Maitland, FL 32751-4591
Phone (407) 564-3459

Other identifiers 1

IdentifierTypeStateIssuer
019204300MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Ashlyn@AdvanceBariatricCounseling.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190822000117 FL Part B Supplier - Clinic/Group Practice 9739417254 Receives reassigned benefits from 5 practitioners
Practice locations: Winter Park, FL

National Provider Directory

National Provider Directory

Locations

1950 Lee Rd
Ste 110
Winter Park, FL 32789
Phone (407) 561-3459

Interoperability endpoints

  • Direct secure messaging: ashlyn@advancebariatriccounseling.com

Practitioners & affiliated clinicians

Practitioners 6

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": "1563148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698796800000",
    "number": "1710539192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 FLORIDA WILLOW AVE",
            "city": "DEBARY",
            "state": "FL",
            "postal_code": "327134865",
            "telephone_number": "850-545-0648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 FLORIDA WILLOW AVE",
            "city": "DEBARY",
            "state": "FL",
            "postal_code": "327134865",
            "telephone_number": "407-564-3459",
            "fax_number": "321-296-6847"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "531 Versailles Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Maitland",
            "state": "FL",
            "postal_code": "327514591",
            "country_code": "US",
            "telephone_number": "407-564-3459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ADVANCE BARIATRIC COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-15",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A",
        "authorized_official_last_name": "DOUGLASS-BARNES",
        "authorized_official_first_name": "ASHLYN",
        "authorized_official_title_or_position": "LCSW/OWNER",
        "authorized_official_telephone_number": "407-564-3459",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019204300",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Ashlyn@AdvanceBariatricCounseling.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "531 Versailles Dr Ste 100",
            "city": "Maitland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327514591",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Debary, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2023; 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.