Professional Counseling Associates Center

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH11233 Issued in FL

Legal business name

PROFESSIONAL COUNSELING ASSOCIATES CENTER

Practice address

316 N John Young Pkwy Ste 4
Kissimmee, FL 34741-4981

Phone

(321) 442-6665

NPI assigned

Oct 7, 2015

Last updated

Dec 4, 2023By 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

Mrs. Alicia C Olivares, PHD, LMHC, MCAPNPI 1417293556

Title

Clinical Supervisor

Phone

(321) 442-6665

Specialties & licenses 2

Addresses

Tax ID family

Professional Counseling Associates Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Professional Counseling Associates Center

  • Case Management Agency
  • Haines City, FL
  • NPI 1790350502
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Alicia Carmen Olivares, MS, PHD

  • Mental Health Counselor
  • Haines City, FL
  • NPI 1417293556

  Addiction (Substance Use Disorder)

  NPD Authorized official

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

{
    "created_epoch": "1444176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701648000000",
    "number": "1821468539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 B ST",
            "city": "HAINES CITY",
            "state": "FL",
            "postal_code": "338445025",
            "telephone_number": "321-442-6665",
            "fax_number": "800-883-7015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 N JOHN YOUNG PKWY STE 4",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414981",
            "telephone_number": "321-442-6665"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "306 S 10th St Ste 360",
            "address_purpose": "LOCATION",
            "city": "Haines City",
            "state": "FL",
            "postal_code": "338445602",
            "country_code": "US",
            "telephone_number": "321-442-6665",
            "fax_number": "800-883-7015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PROFESSIONAL COUNSELING ASSOCIATES CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-07",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A",
        "authorized_official_last_name": "OLIVARES",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CLINICAL SUPERVISOR",
        "authorized_official_telephone_number": "321-442-6665",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PHD, LMHC, MCAP"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "ADC-001479-2014",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH11233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Kissimmee, FL
• Providers in Kissimmee, 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 Dec 4, 2023; 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.