Active NPI
Pivotal Therapy, LLC
- Mental Health Counselor
- Coral Gables, FL
National Provider Identifier
1821603101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Legal business name
- PIVOTAL THERAPY, LLC
- Practice address
- 3081 Salzedo St Ste 202
Coral Gables, FL 33134-6725 - Phone
- (305) 707-1600
- NPI assigned
- Sep 13, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- America Conde, M.S., BCBA
- Title
- Ceo/Executive Clinical Director
- Phone
- (305) 707-1600
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary | ||
| Community/Behavioral Health Agency | 251S00000X |
Addresses
Primary practice location
3081 Salzedo St Ste 202
Coral Gables, FL 33134-6725
Mailing address
5810 SW 14TH St
West Miami, FL 33144-5712
Phone (305) 878-6913
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 115187000 | Medicaid | FL | |
| 115186700 | Medicaid | FL | |
| 024870700 | Medicaid | FL |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599955200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1670284800000",
"number": "1821603101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5810 SW 14TH ST",
"city": "WEST MIAMI",
"state": "FL",
"postal_code": "331445712",
"telephone_number": "305-878-6913"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3081 SALZEDO ST STE 202",
"city": "CORAL GABLES",
"state": "FL",
"postal_code": "331346725",
"telephone_number": "305-707-1600"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PIVOTAL THERAPY, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-09-13",
"last_updated": "2022-12-06",
"certification_date": "2022-12-06",
"status": "A",
"authorized_official_last_name": "CONDE",
"authorized_official_first_name": "AMERICA",
"authorized_official_title_or_position": "CEO/EXECUTIVE CLINICAL DIRECTOR",
"authorized_official_telephone_number": "305-707-1600",
"authorized_official_credential": "M.S., BCBA"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "115187000",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "115186700",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "024870700",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Coral Gables, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.