Emerald Springs Family Counseling LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

EMERALD SPRINGS FAMILY COUNSELING LLC

Practice address

81 St Hwy 83 N Ste a
Defuniak Springs, FL 32433-7487

Phone

(719) 286-3338

NPI assigned

Jan 18, 2024

Organization subpart

No

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

Authorized official

Name

Libby Renae Marcolongo, LMFTNPI 1265085096

Title

Marriage and Family Therapist

Phone

(719) 286-3338

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Libby Renae Marcolongo, LMFT

  • Marriage & Family Therapist
  • Defuniak Springs, FL
  • NPI 1265085096
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1705536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705536000000",
    "number": "1992566889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 ST HWY 83 N STE A",
            "city": "DEFUNIAK SPRINGS",
            "state": "FL",
            "postal_code": "324337487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 ST HWY 83 N STE A",
            "city": "DEFUNIAK SPRINGS",
            "state": "FL",
            "postal_code": "324337487",
            "telephone_number": "719-286-3338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERALD SPRINGS FAMILY COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-18",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A",
        "authorized_official_last_name": "MARCOLONGO",
        "authorized_official_first_name": "LIBBY",
        "authorized_official_middle_name": "RENAE",
        "authorized_official_title_or_position": "MARRIAGE AND FAMILY THERAPIST",
        "authorized_official_telephone_number": "719-286-3338",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Candice Jade Earnest, RBT
• Emerald Coast Medical Services Inc
• Donna Shepherd Ennis, NURSE PRACTITIONER
• Joe R. Evans III, O.D.
• Fawaz Medical and Surgical Clinic, LLC
• Fawzi Fawaz, M. D.
• Patricia A Ferman, MS, RD, LD

• Mental Health Clinic/Center (Including Community Mental Health Center) in Defuniak Springs, FL
• Providers in Defuniak Springs, FL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.