Individual provider Active NPI

Catherine Bukovitz, LMHC

  • Mental Health Counselor
  • Port Charlotte, FL
National Provider Identifier
1881977106
Registry record updated Sep 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH10906 Issued in FL
Practice address
18245 Paulson Dr
Port Charlotte, FL 33954-1019
Phone
(941) 206-2480
NPI assigned
Sep 22, 2011
Last updated
Sep 22, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X MH10906 FL
Mental Health Counselor 101YM0800X MH10906 FL Primary
Professional Counselor 101YP2500X MH10906 FL

Addresses

Primary practice location

18245 Paulson Dr
Port Charlotte, FL 33954-1019

Mailing address

18245 Paulson Dr
Port Charlotte, FL 33954-1019
Phone (941) 206-2480

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231201000652 FL Practitioner - Mental Health Counselor 9234587221 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thriveworks Clinical - Florida IncGroup PAC ID 5496173577, 85 clinicians

Practice addresses (Care Compare)

2852 Remington Green Cir
Suite 203
Tallahassee, FL 32308-1507
Phone (855) 284-7483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH10906FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Thriveworks Clinical - Florida Inc Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

2852 Remington Green Cir
Ste 203
Tallahassee, FL 32308
Phone (239) 999-1029

4115 W Spruce St
Ste 205
Tampa, FL 33607
Phone (813) 413-4663

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1316649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316649600000",
    "number": "1881977106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18245 PAULSON DR",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339541019",
            "telephone_number": "941-206-2480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18245 PAULSON DR",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339541019",
            "telephone_number": "941-206-2480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUKOVITZ",
        "first_name": "CATHERINE",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-22",
        "last_updated": "2011-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "MH10906",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH10906",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "FL",
            "license": "MH10906",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

Verify at the official NPI Registry.