Active NPI
Syrian M McConnico, MA, RMHCI
- Mental Health Counselor
- Maitland, FL
National Provider Identifier
1962915686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 12516
- Practice address
- 2700 Westhall LN Ste 207
Maitland, FL 32751-7478 - Phone
- (407) 636-3532
- NPI assigned
- Nov 16, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 12516 | FL | Primary |
Addresses
Primary practice location
2700 Westhall LN Ste 207
Maitland, FL 32751-7478
Mailing address
769 Pine Island Dr
Melbourne, FL 32940-1709
Phone (321) 271-6454
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12516 | FL | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510790400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1510790400000",
"number": "1962915686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "769 PINE ISLAND DR",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329401709",
"telephone_number": "321-271-6454"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2700 WESTHALL LN STE 207",
"city": "MAITLAND",
"state": "FL",
"postal_code": "327517478",
"telephone_number": "407-636-3532"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCONNICO",
"first_name": "SYRIAN",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "MA, RMHCI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-11-16",
"last_updated": "2017-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "12516",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maitland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.