South Bay Counseling, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

SOUTH BAY COUNSELING, LLC

Practice address

5995 Dr Martin Luther King Jr St S
Saint Petersburg, FL 33705-5541

Phone

(727) 698-0624

Fax

(727) 867-2556

NPI assigned

Sep 1, 2020

Last updated

Sep 1, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John Andrew Bell, LCSWNPI 1447282553

Title

Owner/Manager

Phone

(727) 698-0624

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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.

• John Andrew Bell, M.DIV., MSW, LCSW

  • Clinical Social Worker
  • St Petersburg, FL
  • NPI 1447282553
  NPD Authorized official

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

{
    "created_epoch": "1598918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598918400000",
    "number": "1710591383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5995 DR MARTIN LUTHER KING JR ST S",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337055541",
            "telephone_number": "727-698-0624",
            "fax_number": "727-867-2556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5995 DR MARTIN LUTHER KING JR ST S",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337055541",
            "telephone_number": "727-698-0624",
            "fax_number": "727-867-2556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BAY COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-01",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A",
        "authorized_official_last_name": "BELL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "727-698-0624",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "SW6542",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2020; 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.