The Community Mental Wellness Center

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW12131 Issued in FL

Legal business name

THE COMMUNITY MENTAL WELLNESS CENTER

Practice address

1210 W del Webb Blvd
Sun City Center, FL 33573-5224

Phone

(813) 777-9777

NPI assigned

Sep 8, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Edmond Dubreuil

Title

Owner

Phone

(813) 777-9777

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1410134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411344000000",
    "number": "1902207145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 W DEL WEBB BLVD",
            "city": "SUN CITY CENTER",
            "state": "FL",
            "postal_code": "335735224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 W DEL WEBB BLVD",
            "city": "SUN CITY CENTER",
            "state": "FL",
            "postal_code": "335735224",
            "telephone_number": "813-777-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE COMMUNITY MENTAL WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-08",
        "last_updated": "2014-09-22",
        "status": "A",
        "authorized_official_last_name": "DUBREUIL",
        "authorized_official_first_name": "EDMOND",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-777-9777",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW12131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Sun City Center, FL
• Providers in Sun City Center, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2014; 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.