MS. BROOKE KOONTZ (NPI# 1275198822) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275198822 |
| Entity Type | Individual |
| Full Name | MS. BROOKE KOONTZ |
| Credential | MS |
| Practice Address |
3816 Calliope Ave Port Orange FL 32129-6024 |
| Practice Telephone | 8144428775 |
| Enumeration Date | 2019-05-08 |
| Last Update Date | 2019-05-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
3816 CALLIOPE AVE |
| City | PORT ORANGE |
| State | FL |
| Zip Code | 32129-6024 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982179818 | Port Orange Modern Dentistry, Pa | Dentist | 1765 Dunlawton Ave., Suite 103, Port Orange, FL 32129 | 2018-10-08 |
| 1932698131 | Brittany Michele Claude | Behavioral Analyst | 4647 Clyde Morris Blvd Suite 501, Port Orange, FL 32129 | 2018-05-03 |
| 1760919468 | Makayla Earl | Behavior Technician | 1557 Town Park Dr., Port Orange, FL 32129 | 2017-05-12 |
| 1184157968 | Katie Lynn Weisz | Physician Assistant | 3635 South Clyde Morris Blvd, Suite 100, Port Orage, FL 32129 | 2017-04-07 |
| 1285178319 | Mallory Driggers | Counselor | 980 Canal View Blvd Apt F7, Port Orange, FL 32129 | 2016-12-08 |
| 1912321654 | Edward L. Staudt Dds & Kenneth L. Staudt Dds, Mph | Dentist | 944 Bridgewater Dr., Suite 2-b, Port Orange, FL 32129 | 2014-02-18 |
| 1538411731 | Roberta Ann Gilmartin | Specialist | 1048 W Samms Ave, Port Orange, FL 32129 | 2012-10-11 |
| 1679892996 | Pamela Kirby Pa | Clinic/Center | 4606 South Clyde Morris Boulevard, Suite 1j, Port Orange, FL 32129 | 2010-05-26 |
| 1326376385 | Connie Jeanne Bodnarik | Physical Therapy Assistant | 3780 S Clyde Morris Blvd Apt 1206, Port Orange, FL 32129 | 2009-12-02 |
| 1669645057 | American Family & Sports Chiropractic Center Inc | Chiropractor | 4649 Clyde Morris Blvd Unit 609, Port Orange, FL 32129 | 2008-04-08 |
| Find all providers in zip 32129 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528530466 | Melanie Kirkman | Counselor | 70 Springwood Sq, Port Orange, FL 32129-7605 | 2018-12-17 |
| 1104342062 | Zoe Lyon-goldman | Counselor | 8 Raintree Dr, Port Orange, FL 32127-5937 | 2017-08-22 |
| 1285178319 | Mallory Driggers | Counselor | 980 Canal View Blvd Apt F7, Port Orange, FL 32129 | 2016-12-08 |
| 1942690730 | Cynthia Ann Parkes | Counselor | 1998 Yellowfin Dr, Port Orange, FL 32128-3016 | 2015-01-30 |
| 1730503988 | Joseph Pecchio | Counselor | 900 N Swallowtail Dr Ste 107, Port Orange, FL 32129-6103 | 2014-02-08 |
| 1942636584 | Brenda C. Rockwell | Counselor | 3930 S Nova Rd Ste 307, Port Orange, FL 32127-9293 | 2013-09-14 |
| 1154765840 | Daniel Fleishman | Counselor | 6709 Ferri Circle, Port Orange, FL 32128 | 2013-04-24 |
| 1336420926 | Marilyn Marchese | Counselor | 2268 Las Fuentes Dr, Port Orange, FL 32129-9407 | 2011-09-08 |
| 1366735524 | Scottie Miller | Counselor | 3550 Forest Branch Dr Apt A, Port Orange, FL 32129-8918 | 2011-05-20 |
| 1326349143 | Cynthia Huberdeau-jaeger | Counselor | 3925 S Nova Rd Ste 4, Port Orange, FL 32127-9269 | 2010-11-10 |
| Find all providers in PORT ORANGE | ||||
| City | PORT ORANGE |
| Zip Code | 32129 |
Please comment or provide details below to improve the information on MS. BROOKE KOONTZ.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.