NPIMap

Organization Active NPI

Northside Mental Health

  • Community/Behavioral Health Agency
  • Tampa, FL
National Provider Identifier
1922390715
Registry record updated May 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
SW7140 Issued in FL
Legal business name
NORTHSIDE MENTAL HEALTH
Practice address
12512 Bruce B Downs Blvd
Tampa, FL 33612-9209
Phone
(813) 977-8700
NPI assigned
May 11, 2011
Last updated
May 11, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2011

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

Authorized official

Name
Mrs. Elaine Churton I, LCSW
Title
Director
Phone
(813) 977-8700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X SW7140 FL Primary

Addresses

Primary practice location

12512 Bruce B Downs Blvd
Tampa, FL 33612-9209

Mailing address

12512 Bruce B Downs Blvd
Tampa, FL 33612-9209
Phone (813) 977-8700

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1305072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305072000000",
    "number": "1922390715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12512 BRUCE B DOWNS BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336129209",
            "telephone_number": "813-977-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12512 BRUCE B DOWNS BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336129209",
            "telephone_number": "813-977-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSIDE MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-11",
        "last_updated": "2011-05-11",
        "status": "A",
        "authorized_official_last_name": "CHURTON",
        "authorized_official_first_name": "ELAINE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "813-977-8700",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_name_suffix": "I",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "SW7140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2011; 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.