NPIMap

Organization Active NPI

Mangrove Therapy Group LLC

  • Mental Health Counselor
  • Delray Beach, FL
National Provider Identifier
1942952213
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
MANGROVE THERAPY GROUP LLC
Practice address
401 Linton Blvd Ste 200a
Delray Beach, FL 33444-8157
Phone
(564) 404-0165
Fax
(561) 847-3299
NPI assigned
Jan 19, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

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

Authorized official

Name
Brian Gong, LMHCNPI 1295263473
Title
Owner/Practitioner
Phone
(561) 404-0165

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X

Addresses

Primary practice location

401 Linton Blvd Ste 200a
Delray Beach, FL 33444-8157

Mailing address

401 Linton Blvd Ste 200a
Delray Beach, FL 33444-8157
Phone (564) 404-0165

Other names 1

  • Mangrove Therapy Group Doing business as

National Provider Directory

National Provider Directory

Locations

401 Linton Blvd
Ste 200A
Delray Beach, FL 33444
Phone (561) 404-0165

Practitioners & affiliated clinicians

Practitioners 3

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": "1642550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642550400000",
    "number": "1942952213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 LINTON BLVD STE 200A",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334448157",
            "telephone_number": "564-404-0165",
            "fax_number": "561-847-3299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 LINTON BLVD STE 200A",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334448157",
            "telephone_number": "564-404-0165",
            "fax_number": "561-847-3299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANGROVE THERAPY GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-19",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A",
        "authorized_official_last_name": "GONG",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "OWNER/PRACTITIONER",
        "authorized_official_telephone_number": "561-404-0165",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mangrove Therapy Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Delray Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; 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.