Active NPI
Ivory Tierra Renthrope III
- Mental Health Counselor
- Melbourne, FL
National Provider Identifier
1932546983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 3270 Suntree Blvd
Melbourne, FL 32940-7530 - Phone
- (321) 610-7949
- NPI assigned
- May 31, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary | ||
| Case Manager/Care Coordinator | 171M00000X |
Addresses
Primary practice location
3270 Suntree Blvd
Melbourne, FL 32940-7530
Mailing address
3780 Erie St
Cocoa, FL 32926-3837
Phone (321) 271-7762
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369958400000",
"number": "1932546983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3780 ERIE ST",
"city": "COCOA",
"state": "FL",
"postal_code": "329263837",
"telephone_number": "321-271-7762"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3270 SUNTREE BLVD",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329407530",
"telephone_number": "321-610-7949"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENTHROPE",
"first_name": "IVORY",
"middle_name": "TIERRA",
"name_suffix": "III",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-05-31",
"last_updated": "2013-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.