NPIMap

Organization Active NPI

Breakwater Psychotherapy, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Delray Beach, FL
National Provider Identifier
1811640592
Registry record updated Mar 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
BREAKWATER PSYCHOTHERAPY, LLC
Practice address
550 SE 6TH Ave Ste 200
Delray Beach, FL 33483-5306
Phone
(954) 372-6582
NPI assigned
Feb 1, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2022

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

Authorized official

Name
Benjamin Paul Heinrichs, MA, LMHCNPI 1902194863
Title
Cofounder
Phone
(954) 372-6582

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Counseling PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC1900X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

550 SE 6TH Ave Ste 200
Delray Beach, FL 33483-5306

Mailing address

5949 NW 63Rd Way
Parkland, FL 33067-1525
Phone (641) 485-8750

Other practice location 1

5949 NW 63rd Way
Parkland, FL 33067-1525
Phone (641) 485-8750

National Provider Directory

National Provider Directory

Locations

2200 NW Corporate Blvd
Ste 100
Boca Raton, FL 33431
Phone (954) 507-2832

550 SE 6th Ave
#200
Delray Beach, FL 33483
Phone (561) 408-8500

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1643673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647388800000",
    "number": "1811640592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5949 NW 63RD WAY",
            "city": "PARKLAND",
            "state": "FL",
            "postal_code": "330671525",
            "telephone_number": "641-485-8750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 SE 6TH AVE STE 200",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334835306",
            "telephone_number": "954-372-6582"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5949 NW 63rd Way",
            "address_purpose": "LOCATION",
            "city": "Parkland",
            "state": "FL",
            "postal_code": "330671525",
            "country_code": "US",
            "telephone_number": "641-485-8750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BREAKWATER PSYCHOTHERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-01",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A",
        "authorized_official_last_name": "HEINRICHS",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "COFOUNDER",
        "authorized_official_telephone_number": "954-372-6582",
        "authorized_official_credential": "MA, LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; 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.