Sunshine State Counseling Center, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW12686 Issued in FL

Legal business name

SUNSHINE STATE COUNSELING CENTER, LLC

Practice address

3575 Bonita Beach Rd Ste 1
Bonita Springs, FL 34134-4105

Phone

(239) 495-7722

Fax

(239) 443-4577

NPI assigned

Jul 18, 2016

Organization subpart

No

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

Authorized official

Name

Diana Milena Salazar, LCSW-SNPI 1285995357

Title

Owner

Phone

(239) 495-7722

Specialties & licenses 1

Addresses

Other identifiers 3

Tax ID family

Sunshine State Counseling Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Sunshine State Counseling Center LLC

  • Community/Behavioral Health Agency
  • Fort Myers, FL
  • NPI 1699152553
  NPD tax ID

Locations

Practitioners 5

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

• Diana Milena Salazar, LCSW

  • Clinical Social Worker
  • Bonita Springs, FL
  • NPI 1285995357
  NPD Authorized official
• Elisabeth Martin, IMH

  • Mental Health Counselor
  • Bonita Springs, FL
  • NPI 1518605476
  NPD
• Courtney Marie Anderson, LMHC

  • Counselor
  • Fort Myers, FL
  • NPI 1720662703
  NPD (past)
• Alexis Haley-Echo Fischer

  • Clinical Social Worker
  • Ocala, FL
  • NPI 1164999561
  NPD (past)
• Ana Hill, LMHC

  • Mental Health Counselor
  • Bonita Springs, FL
  • NPI 1447106570
  NPD (past)

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

{
    "created_epoch": "1468800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703635200000",
    "number": "1962855668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3575 BONITA BEACH RD STE 1",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341344105",
            "telephone_number": "239-495-7722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3575 BONITA BEACH RD STE 1",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341344105",
            "telephone_number": "239-495-7722",
            "fax_number": "239-443-4577"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13130 Westlinks Ter Ste 8",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339138651",
            "country_code": "US",
            "telephone_number": "239-495-7722",
            "fax_number": "234-443-4577",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SUNSHINE STATE COUNSELING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-18",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A",
        "authorized_official_last_name": "SALAZAR",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "MILENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-495-7722",
        "authorized_official_credential": "LCSW-S"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW12686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1163217",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014047700",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1117901",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Sunrise Therapy Services LLC
• Sunrise Transportation Inc
• Sunshine State Podiatry LLC
• Sunshine TCM Corp.
• Sonal Sura, MD
• Surgcenter of Pine Ridge LLC
• SW Florida Wellness Corp

• Clinical Social Worker in Bonita Springs, FL
• Providers in Bonita Springs, 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 Dec 27, 2023; 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.