Mycle Pourbaix, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW16747 Issued in FL

Practice address

900 SE Ocean Blvd Ste 340
Stuart, FL 34994-3502

Phone

(772) 322-0343

NPI assigned

Nov 8, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Tykes & Teens, Inc

  • Case Management Agency
  • Stuart, FL
  • NPI 1417624511
  NPD
• Tykes & Teens, Inc.

  • Community/Behavioral Health Agency
  • Stuart, FL
  • NPI 1093710303

  Clinical

  NPD (past)

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

{
    "created_epoch": "1573171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1841835311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 SE OCEAN BLVD STE 340",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349943502",
            "telephone_number": "772-322-0343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 SE OCEAN BLVD STE 340",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349943502",
            "telephone_number": "772-322-0343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POURBAIX",
        "first_name": "MYCLE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-08",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW16747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Josephine Potter
• Justin Pottlitzer
• Rechelle Poulos
• Kim E Pound, L.M.T.
• Sierra Pound
• Keyonna Powell
• Michael Powell
• Noah S Powell
• Power Orthodonitcs
• Power Orthodontics

• Clinical Social Worker in Stuart, FL
• Providers in Stuart, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2024; 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.