NPIMap

Organization Active NPI

Devereux

  • Mental Health Counselor
  • Winter Park, FL
National Provider Identifier
1912040403
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH5420 Issued in FL
Legal business name
DEVEREUX
Practice address
501 N Wymore Rd
Winter Park, FL 32789-2808
Phone
(407) 975-2565
Fax
(407) 975-2585
NPI assigned
Feb 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. John G Williams, LMHC
Title
Therapist
Phone
(407) 975-2565

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X MH5420 FL Primary

Addresses

Primary practice location

501 N Wymore Rd
Winter Park, FL 32789-2808

Mailing address

501 N Wymore Rd
Winter Park, FL 32789-2808
Phone (407) 975-2565

National Provider Directory

National Provider Directory

Locations

501 N Wymore Rd
Winter Park, FL 32789
Phone (407) 247-0022

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1912040403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 N WYMORE RD",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327892808",
            "telephone_number": "407-975-2565",
            "fax_number": "407-975-2585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N WYMORE RD",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327892808",
            "telephone_number": "407-975-2565",
            "fax_number": "407-975-2585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVEREUX",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "407-975-2565",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH5420",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 22, 2020; 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.