OrganizationActive
Center for Behavioral Medicine
NPI 1003348855 · Mental Health Counselor · Port Orange, FL
Provider details
- NPI number
- 1003348855
- Entity type
- Organization
- Primary specialty
- Mental Health CounselorBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Shane Porter, Managing Partner(386) 957-3905
- License
- MH6409 (FL)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Established profile(70/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1730 Dunlawton Ave
Suite 3
Port Orange, FL 32127-8985
Phone: (138) 695-7390
Street-level locationGet directions
Mailing address
1730 Dunlawton Ave
Port Orange, FL 32127-8985
Registry dates
- Enumerated
- 2017-03-31
- Last updated
- 2017-03-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.