Emerald Coast Assessment and Counseling Center, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH8518 Issued in FL

Legal business name

EMERALD COAST ASSESSMENT AND COUNSELING CENTER, LLC

Practice address

4400 Bayou Blvd
Suite 38
Pensacola, FL 32503-2673

Phone

(866) 960-8806

Fax

(866) 960-8806

NPI assigned

Aug 6, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Joshua Lutz, ED.S. , NCSP

Title

School Psychologist

Phone

(866) 960-8806

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1249516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249516800000",
    "number": "1902037013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 BAYOU BLVD",
            "address_2": "SUITE 38",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032673",
            "telephone_number": "866-960-8806",
            "fax_number": "866-960-8806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 BAYOU BLVD",
            "address_2": "SUITE 38",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032673",
            "telephone_number": "866-960-8806",
            "fax_number": "866-960-8806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERALD COAST ASSESSMENT AND COUNSELING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-06",
        "last_updated": "2009-08-06",
        "status": "A",
        "authorized_official_last_name": "LUTZ",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "SCHOOL PSYCHOLOGIST",
        "authorized_official_telephone_number": "866-960-8806",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ED.S. , NCSP"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH8518",
            "primary": true
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, School",
            "state": "FL",
            "license": "SS795",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2009; 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.