Healthcare Provider Details

I. General information

NPI: 1952214017
Provider Name (Legal Business Name): MENTAL MASSAGE COUNSELING, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 N HIGHWAY A1A STE A104
JUPITER FL
33477-4561
US

IV. Provider business mailing address

725 N HIGHWAY A1A STE A104
JUPITER FL
33477-4561
US

V. Phone/Fax

Practice location:
  • Phone: 561-802-7922
  • Fax:
Mailing address:
  • Phone: 561-802-7922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: NAKHARY ESPARRAGOZA BRUCE
Title or Position: PRESIDENT / OWNER
Credential: LMHC
Phone: 561-802-7922