OrganizationActive
Experiential Healing PLLC
NPI 1538961164 · Mental Health Counselor · Freeport, FL
Provider details
- NPI number
- 1538961164
- Entity type
- Organization
- Primary specialty
- Mental Health CounselorBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Shannon Brunson, Owner/Ceo(850) 978-2852
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Established profile(59/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
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
188 Lodge Rd
Freeport, FL 32439-2212
Phone: (850) 333-6283
Street-level locationGet directions
Mailing address
188 Lodge Rd
Freeport, FL 32439-2212
Additional practice locations (1)
- 4400 E Highway 20 Ste 306Niceville, FL 32578-7703Phone: (850) 333-6283Fax: (850) 535-0003
Registry dates
- Enumerated
- 2025-03-25
- Last updated
- 2026-02-11
- Certified
- 2026-02-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.