Phoenix Mental Health, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH12356 Issued in FL

Legal business name

PHOENIX MENTAL HEALTH, LLC

Practice address

2440 SE Federal Hwy
Stuart, FL 34994-4531

Phone

(561) 229-8314

NPI assigned

Jul 21, 2014

Last updated

Jul 21, 2014By 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

Lynn E Varela, LMHC

Title

Owner

Phone

(561) 229-8314

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1405900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405900800000",
    "number": "1780091884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 SE FEDERAL HWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349944531",
            "telephone_number": "561-229-8314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 SE FEDERAL HWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349944531",
            "telephone_number": "561-229-8314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX MENTAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-21",
        "last_updated": "2014-07-21",
        "status": "A",
        "authorized_official_last_name": "VARELA",
        "authorized_official_first_name": "LYNN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-229-8314",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH12356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Stuart, FL
• Providers in Stuart, 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 Jul 21, 2014; 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.