Active NPI
Skylar James Purvis, RMHCI, RMFTI
- Mental Health Counselor
- Winter Park, FL
National Provider Identifier
1871083469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- IMH22549
- Practice address
- 2479 Aloma Ave
Winter Park, FL 32792-2541 - Phone
- (497) 657-6692
- NPI assigned
- May 18, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-18-53308 | ||
| Behavior Technician | 106S00000X | |||
| Mental Health Counselor | 101YM0800X | IMH22549 | FL | Primary |
Addresses
Primary practice location
2479 Aloma Ave
Winter Park, FL 32792-2541
Mailing address
1007 Celebration Ave Apt 203
Celebration, FL 34747-4862
Phone (850) 368-7447
Other practice location 1
1320 Jersey Ave
Saint Cloud, FL 34769-4245
Phone (689) 210-7718
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| IMH22549 | Other | FL | STATE OF FLORIDA |
| RBT-18-53308 | Other | RBT | |
| 022030900 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMH22549 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718668800000",
"number": "1871083469",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1007 CELEBRATION AVE APT 203",
"city": "CELEBRATION",
"state": "FL",
"postal_code": "347474862",
"telephone_number": "850-368-7447"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2479 ALOMA AVE",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327922541",
"telephone_number": "497-657-6692"
}
],
"practiceLocations": [
{
"address_1": "1320 Jersey Ave",
"address_purpose": "LOCATION",
"city": "Saint Cloud",
"state": "FL",
"postal_code": "347694245",
"country_code": "US",
"telephone_number": "689-210-7718",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PURVIS",
"first_name": "SKYLAR",
"middle_name": "JAMES",
"credential": "RMHCI, RMFTI",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-05-18",
"last_updated": "2024-06-18",
"certification_date": "2024-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": "RBT-18-53308",
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "IMH22549",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF FLORIDA",
"identifier": "IMH22549",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RBT",
"identifier": "RBT-18-53308",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "022030900",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Winter Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.