Gwendolyn Phillips, M.A, MCAP, IMH 9889

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

IMH 9889 Issued in FL

Practice address

1280 N Congress Ave
West Palm Beach, FL 33409-6377

Phone

(561) 228-1598

NPI assigned

Feb 3, 2010

Last updated

Feb 22, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Gwendolyn Prentina Phillips Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Emerge Recovery Associates LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • West Palm Beach, FL
  • NPI 1932567930
  Authorized official Same address or phone

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

{
    "created_epoch": "1265155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487721600000",
    "number": "1730411638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1280 N CONGRESS AVE",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334096377",
            "telephone_number": "561-228-1598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1280 N CONGRESS AVE",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334096377",
            "telephone_number": "561-228-1598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "GWENDOLYN",
        "name_prefix": "Mrs.",
        "credential": "M.A, MCAP, IMH 9889",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-03",
        "last_updated": "2017-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "ADC-012635-2016",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH 9889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GWENDOLYN",
            "last_name": "PHILLIPS",
            "middle_name": "PRENTINA",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michael Philippe-Auguste, M.D
• Osly Philistin, D.C.
• Rose Philius, ARNP
• Phillippe Martineau MD. Inc
• Courtney Elizabeth Phillips, M.D.
• Janice C Phillips, APRN
• Karen Bress Phillips, LCSW
• Mark G Phillips, MD
• Paula Phillips
• Tamaru Phillips

• Mental Health Counselor in West Palm Beach, FL
• Providers in West Palm Beach, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2017; 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.