Individual provider Active NPI

Fhara D Guadalupe, MS

  • Mental Health Counselor
  • Miami, FL
National Provider Identifier
1023476025
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
PMT293 Issued in FL
Practice address
22790 SW 112TH Ave
Miami, FL 33170-7602
Phone
(305) 235-2616
Fax
(305) 235-6178
NPI assigned
Feb 4, 2016
Last updated
Mar 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Mental Health Counselor 101YM0800X PMT293 FL Primary

Addresses

Primary practice location

22790 SW 112TH Ave
Miami, FL 33170-7602

Mailing address

8255 SW 72ND CT Unit 532
Miami, FL 33143-4265
Phone (786) 339-4384

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
PMT293FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1454544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1023476025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8255 SW 72ND CT UNIT 532",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331434265",
            "telephone_number": "786-339-4384"
        },
        {
            "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": "GUADALUPE",
        "first_name": "FHARA",
        "middle_name": "D",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-04",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "PMT293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.