Center of Life Health, Inc.

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

MH3692 Issued in FL

Legal business name

CENTER OF LIFE HEALTH, INC.

Practice address

322 SW Ocean Blvd
Stuart, FL 34994

Phone

(772) 220-4556

Fax

(772) 220-2214

NPI assigned

Nov 14, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Kathleen Sue Fuller, L.M.H.C.

Title

Director

Phone

(772) 220-4556

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286323200000",
    "number": "1750453270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 SW OCEAN BLVD",
            "city": "STUART",
            "state": "FL",
            "postal_code": "34994",
            "telephone_number": "772-220-4556",
            "fax_number": "772-220-2214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 SW OCEAN BLVD",
            "city": "STUART",
            "state": "FL",
            "postal_code": "34994",
            "telephone_number": "772-220-4556",
            "fax_number": "772-220-2214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER OF LIFE HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2010-10-06",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "772-220-4556",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "L.M.H.C."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "MH3692",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "FL",
            "license": "MH3692",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Stuart, FL
• Providers in Stuart, FL by specialty
• Addiction (Substance Use Disorder) Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2010; 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.