Ann E Imburgio, L.M.H.C.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH4741 Issued in FL

Practice address

11 1St St SE
Fort Walton Beach, FL 32548-5839

Phone

(850) 244-2825

Fax

(850) 664-9146

NPI assigned

Jan 15, 2008

Last updated

Jan 15, 2008By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1200355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200355200000",
    "number": "1811173214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 1ST ST SE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325485839",
            "telephone_number": "850-244-2825",
            "fax_number": "850-664-9146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 1ST ST SE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325485839",
            "telephone_number": "850-244-2825",
            "fax_number": "850-664-9146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMBURGIO",
        "first_name": "ANN",
        "middle_name": "E",
        "credential": "L.M.H.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-15",
        "last_updated": "2008-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH4741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Fort Walton Beach, FL
• Providers in Fort Walton 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 Jan 15, 2008; 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.