Elisa Amaris Niles Thorne, L.M.H.C., N.C.C.

Individual provider Active NPI Mental Health Counselor · North Port, FL

NPI 1972858702 · NPPES record last updated Apr 26, 2023

Key facts

NPI
1972858702
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
MH11000 (FL)
Practice address
2571 N Toledo Blade Blvd Unit 2
North Port, FL 34289-9351
Phone
(407) 270-2491
NPI assigned
Jul 18, 2012
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
MH11000FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Soundmind Counseling & Consulting Services, LLC. Mental Health Current
since May 7, 2023
Accepting new patients

Locations

2571 N Toledo Blade Blvd
Unit 2
North Port, FL 34289
Phone (407) 270-2491

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH11000 FL Yes

Addresses

Primary practice location

2571 N Toledo Blade Blvd Unit 2
North Port, FL 34289-9351

Mailing address

2571 N Toledo Blade Blvd Unit 2
North Port, FL 34289-9351
Phone (407) 270-2491

Other names

  • Elisa Amaris Niles Former name

Other providers in North Port, FL

All providers in North Port, FL · Mental Health Counselor in Florida

Sources for this page

Verify at the official NPI Registry.