NPIMap

Organization Active NPI

Calm Waters Counseling Group

  • Mental Health Counselor
  • Fort Myers, FL
National Provider Identifier
1871326470
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
CALM WATERS COUNSELING GROUP
Practice address
12670 New Brittany Blvd Ste 101
Fort Myers, FL 33907-3650
Phone
(239) 837-8555
Fax
(239) 837-8568
NPI assigned
Aug 21, 2024
Last updated
Aug 21, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Authorized official

Name
Emely FernandezNPI 1003358987
Title
Ceo
Phone
(239) 837-8555

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
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

12670 New Brittany Blvd Ste 101
Fort Myers, FL 33907-3650

Mailing address

12670 New Brittany Blvd Ste 101
Fort Myers, FL 33907-3650
Phone (239) 837-8555

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241010004070 FL Part B Supplier - Clinic/Group Practice 4880126176 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Myers, FL

National Provider Directory

National Provider Directory

Locations

12670 New Brittany Blvd
Ste 101
Fort Myers, FL 33907
Phone (239) 354-7227

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1724198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724198400000",
    "number": "1871326470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12670 NEW BRITTANY BLVD STE 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073650",
            "telephone_number": "239-837-8555",
            "fax_number": "239-837-8568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12670 NEW BRITTANY BLVD STE 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073650",
            "telephone_number": "239-837-8555",
            "fax_number": "239-837-8568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALM WATERS COUNSELING GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-21",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "EMELY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "239-837-8555"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; 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.