Wise Minds Counseling, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH 10486 Issued in FL

Legal business name

WISE MINDS COUNSELING, LLC

Practice address

1150 N 12TH Ave
Pensacola, FL 32501-3308

Phone

(850) 602-2411

Fax

(850) 469-1081

NPI assigned

Mar 29, 2017

Organization subpart

No

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

Authorized official

Name

Kelcey Killingsworth, PHD, LMHC, NCC

Title

Owner/Therapist

Phone

(850) 602-2411

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1490745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490745600000",
    "number": "1780116822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 N 12TH AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325013308",
            "telephone_number": "850-602-2411",
            "fax_number": "850-469-1081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 N 12TH AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325013308",
            "telephone_number": "850-602-2411",
            "fax_number": "850-469-1081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISE MINDS COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-29",
        "last_updated": "2017-03-29",
        "status": "A",
        "authorized_official_last_name": "KILLINGSWORTH",
        "authorized_official_first_name": "KELCEY",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "850-602-2411",
        "authorized_official_credential": "PHD, LMHC, NCC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 10486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Pensacola, FL
• Providers in Pensacola, FL by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.