NPI Code Detail JSON Logo

1053073304 NPI number — PREVAIL AND PROGRESS COUNSELING PLLC

NPI Number: 1053073304
Health Care Provider/Practitioner: PREVAIL AND PROGRESS COUNSELING PLLC

Information about “1053073304” NPI (PREVAIL AND PROGRESS COUNSELING PLLC) exists in 1053073304 in HTML format HTML  |  1053073304 in plain Text format TXT  |  1053073304 in PDF (Portable Document Format) PDF  |  1053073304 in an XML format XML  formats.

NPI Number : 1053073304 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1053073304",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "PREVAIL AND PROGRESS COUNSELING PLLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "18704 SW 100TH AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CUTLER BAY",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33157-6906",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "305-812-6018",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "18704 SW 100TH AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CUTLER BAY",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "33157-6906",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "305-812-6018",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/13/2021",
    "LastUpdateDate": "10/13/2021",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "CRIDER",
    "AuthorizedOfficialFirstName": "TIFFANY",
    "AuthorizedOfficialMiddleName": "SIMONE",
    "AuthorizedOfficialTitle": "CEO",
    "AuthorizedOfficialNamePrefix": "MS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "LMHC",
    "AuthorizedOfficialTelephoneNumber": "786-300-7080",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "101YA0400X",
          "TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QM0801X",
          "TaxonomyName": "Mental Health Clinic/Center (Including Community Mental Health Center)",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QM0850X",
          "TaxonomyName": "Adult Mental Health Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        }
      ]
    }
  }
}
                
            

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