Organization Active NPI

Hibiscus Counseling Center PLLC

  • Clinical Social Worker
  • Port Saint Lucie, FL
National Provider Identifier
1851630180
Registry record updated Mar 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW9799 Issued in FL
Legal business name
HIBISCUS COUNSELING CENTER PLLC
Practice address
549 SE Starflower Ave
Port Saint Lucie, FL 34983-4578
Phone
(772) 249-8255
Fax
(772) 249-8256
NPI assigned
Feb 6, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2013

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

Authorized official

Name
Magalys Koch, LCSWNPI 1730407446
Title
Owner/ Practioner
Phone
(772) 249-8255

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X SW9799 FL Primary

Addresses

Primary practice location

549 SE Starflower Ave
Port Saint Lucie, FL 34983-4578

Mailing address

1981 SE Port St Lucie Blvd
Suite 2
Port Saint Lucie, FL 34952-5555
Phone (772) 249-8255

Other identifiers 1

IdentifierTypeStateIssuer
DI480ZOtherFLPTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130328000047 FL Part B Supplier - Clinic/Group Practice 1052556883 Receives reassigned benefits from 1 practitioner
Practice locations: Port St Lucie, FL

National Provider Directory

National Provider Directory

Locations

1981 SE Port St Lucie Blvd
Ste 2
Port St Lucie, FL 34952
Phone (772) 249-8255

718 SW Port Saint Lucie Blvd
Ste E5
Port St Lucie, FL 34953
Phone (772) 249-8255

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": "1360108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364342400000",
    "number": "1851630180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1981 SE PORT ST LUCIE BLVD",
            "address_2": "SUITE 2",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349525555",
            "telephone_number": "772-249-8255",
            "fax_number": "772-249-8256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "549 SE STARFLOWER AVE",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349834578",
            "telephone_number": "772-249-8255",
            "fax_number": "772-249-8256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIBISCUS COUNSELING CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-06",
        "last_updated": "2013-03-27",
        "status": "A",
        "authorized_official_last_name": "KOCH",
        "authorized_official_first_name": "MAGALYS",
        "authorized_official_title_or_position": "OWNER/ PRACTIONER",
        "authorized_official_telephone_number": "772-249-8255",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW9799",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "DI480Z",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.