Organization Active NPI

Learning to Heal Therapy, LLC

  • Clinical Social Worker
  • Fort Walton Beach, FL
National Provider Identifier
1972210664
Registry record updated Nov 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
LEARNING TO HEAL THERAPY, LLC
Practice address
1724 Quail Path
Fort Walton Beach, FL 32547-6812
Phone
(850) 684-0291
NPI assigned
Nov 1, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2022

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

Authorized official

Name
Jesselin Mendoza, MSW, LCSW
Title
Ceo
Phone
(850) 684-0291

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

1724 Quail Path
Fort Walton Beach, FL 32547-6812

Mailing address

1724 Quail Path
Fort Walton Beach, FL 32547-6812
Phone (850) 684-0291

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1667260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667260800000",
    "number": "1972210664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1724 QUAIL PATH",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476812",
            "telephone_number": "850-684-0291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1724 QUAIL PATH",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476812",
            "telephone_number": "850-684-0291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEARNING TO HEAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-01",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A",
        "authorized_official_last_name": "MENDOZA",
        "authorized_official_first_name": "JESSELIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "850-684-0291",
        "authorized_official_credential": "MSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.