Individual provider Active NPI

Maria O Hernandez, MS

  • Mental Health Counselor
  • Miami, FL
National Provider Identifier
1003213703
Registry record updated Dec 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH18570 Issued in FL
Practice address
22790 SW 112TH Ave
Miami, FL 33170-7602
Phone
(305) 235-2616
Fax
(305) 235-6178
NPI assigned
Nov 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH18570 FL Primary

Addresses

Primary practice location

22790 SW 112TH Ave
Miami, FL 33170-7602

Mailing address

22790 SW 112TH Ave
Miami, FL 33170-7602
Phone (305) 235-2616

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240215000565 FL Practitioner - Mental Health Counselor 3375987639 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
May accept Medicare assignment
Group practices
Agape Network, Inc.Group PAC ID 5799817094, 6 clinicians

Practice addresses (Care Compare)

22790 SW 112TH Ave
South Florida Jail Ministries Inc
Miami, FL 33170-7602
Phone (305) 235-2616

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
MH18570FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Agape Network, Inc. CurrentSince Jan 10, 2024 Accepting new patients
Ahn LLC CurrentSince Apr 9, 2024 Accepting new patients
Agape Network, Inc. Counselor CurrentSince Jan 10, 2024 Accepting new patients
True Life Behavioral Network, Inc CurrentSince Apr 1, 2024 Accepting new patients
Universal Mental Center Corp CurrentSince Sep 23, 2024 Accepting new patients

Locations

3901 NW 79th Ave
Ste 120
Doral, FL 33166
Phone (305) 552-7660

3498 NW 7th St
Miami, FL 33125
Phone (786) 332-2392

22790 SW 112th Ave
Fl Jail
Miami, FL 33170
Phone (305) 235-2616

22790 SW 112th Ave
Miami, FL 33170
Phone (305) 235-2616

13500 SW 88th St
Ste 129
Miami, FL 33186
Phone (786) 628-2530

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1416787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1003213703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22790 SW 112TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331707602",
            "telephone_number": "305-235-2616",
            "fax_number": "305-235-6178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22790 SW 112TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331707602",
            "telephone_number": "305-235-2616",
            "fax_number": "305-235-6178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "MARIA",
        "middle_name": "O",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-24",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH18570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.