Individual provider Active NPI

Miriam E Stevens, LMHC

  • Mental Health Counselor
  • Fort Lauderdale, FL
National Provider Identifier
1003965252
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH3072 Issued in FL
Practice address
1040 Bayview Dr
Suite 534
Fort Lauderdale, FL 33304-2522
Phone
(954) 829-0931
Fax
(954) 742-5327
NPI assigned
Jan 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 MH3072 FL Primary

Addresses

Primary practice location

1040 Bayview Dr
Suite 534
Fort Lauderdale, FL 33304-2522

Mailing address

3521 NW 75TH Ter
Lauderhill, FL 33319-4928
Phone (954) 829-0931

Other identifiers 1

IdentifierTypeStateIssuer
Z5977OtherFLBLUE CROSS BLUE SHIELD FL

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
I20231204003374 FL Practitioner - Mental Health Counselor 4688022411 Practice locations: Davie, FL

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

7450 Griffin Rd
Suite 250
Davie, FL 33314-4104
Phone (954) 475-9503

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH3072FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003965252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3521 NW 75TH TER",
            "city": "LAUDERHILL",
            "state": "FL",
            "postal_code": "333194928",
            "telephone_number": "954-829-0931",
            "fax_number": "954-742-5327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 BAYVIEW DR",
            "address_2": "SUITE 534",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333042522",
            "telephone_number": "954-829-0931",
            "fax_number": "954-742-5327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "MIRIAM",
        "middle_name": "E",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH3072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD FL",
            "identifier": "Z5977",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.