Organization Active NPI

Pivotal Therapy, LLC

  • Mental Health Counselor
  • Coral Gables, FL
National Provider Identifier
1821603101
Registry record updated Dec 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
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

Updated by the provider on Dec 6, 2022

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)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 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

IdentifierTypeStateIssuer
115187000MedicaidFL
115186700MedicaidFL
024870700MedicaidFL

National Provider Directory

National Provider Directory

NPI 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.

Verify at the official NPI Registry.