Abundance, Mental Health Counseling LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH12709 Issued in FL

Legal business name

ABUNDANCE, MENTAL HEALTH COUNSELING LLC

Practice address

32313 Broadway St,
Suite 310
Sebring, FL 33870

Phone

(863) 446-2853

NPI assigned

Sep 7, 2016

Organization subpart

No

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

Authorized official

Name

Mrs. Amanda Elaine Hollywood, L.M.H.C.

Title

Manager

Phone

(863) 446-2853

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1473206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473206400000",
    "number": "1962959940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32313 BROADWAY ST.",
            "address_2": "SUITE 310",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "33870",
            "telephone_number": "863-446-2853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32313 BROADWAY ST,",
            "address_2": "SUITE 310",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "33870",
            "telephone_number": "863-446-2853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABUNDANCE, MENTAL HEALTH COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-07",
        "last_updated": "2016-09-07",
        "status": "A",
        "authorized_official_last_name": "HOLLYWOOD",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "ELAINE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "863-446-2853",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "L.M.H.C."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH12709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012332100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Sebring, FL
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2016; 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.