Organization Active NPI

Counseling Associates of Ormond Beach

  • Clinical Psychologist
  • Ormond Beach, FL
National Provider Identifier
1841469970
Registry record updated Feb 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY3048 Issued in FL
Legal business name
COUNSELING ASSOCIATES OF ORMOND BEACH
Practice address
150 S Beach St
Suite #B
Ormond Beach, FL 32174-6373
Phone
(386) 672-1776
Fax
(386) 672-9934
NPI assigned
Feb 22, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2008

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

Authorized official

Name
Dr. Malcolm J Graham III, PH.D
Title
Owner
Phone
(386) 672-1776

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X PY3048 FL Primary

Addresses

Primary practice location

150 S Beach St
Suite #B
Ormond Beach, FL 32174-6373

Mailing address

150 S Beach St
Suite #B
Ormond Beach, FL 32174-6373
Phone (386) 672-1776

National Provider Directory

National Provider Directory

Locations

150 S Beach St
#B
Ormond Beach, FL 32174
Phone (386) 672-1776

Practitioners & affiliated clinicians

Practitioners 1

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": "1203638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203638400000",
    "number": "1841469970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 S BEACH ST",
            "address_2": "SUITE #B",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321746373",
            "telephone_number": "386-672-1776",
            "fax_number": "386-672-9934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S BEACH ST",
            "address_2": "SUITE #B",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321746373",
            "telephone_number": "386-672-1776",
            "fax_number": "386-672-9934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNSELING ASSOCIATES OF ORMOND BEACH",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-22",
        "last_updated": "2008-02-22",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "MALCOLM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-672-1776",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY3048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ormond Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.