Individual provider Active NPI

Elizabeth Vicens-Fernandez, LMHC

  • Mental Health Counselor
  • Miami, FL
National Provider Identifier
1033534474
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH5828 Issued in FL
Practice address
9350 Sunset Dr Ste 151
Miami, FL 33173-3286
Phone
(786) 548-1022
NPI assigned
Feb 21, 2014
Last updated
Aug 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

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 MH5828 FL Primary

Addresses

Primary practice location

9350 Sunset Dr Ste 151
Miami, FL 33173-3286

Mailing address

9350 Sunset Dr Ste 151
Miami, FL 33173-3286
Phone (786) 548-1022

Other practice location 1

3436 Marinatown Ln Ste 151
Fort Myers, FL 33903-7058
Phone (786) 548-1022 ext. 1022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: No
  • 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
I20240105003917 FL Practitioner - Mental Health Counselor 8628429487 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH5828FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Dade Family Counseling Community Mental Health Center, Inc CurrentSince Jan 1, 2024 Accepting new patients

Locations

1951 NW 17th Ave
Miami, FL 33125
Phone (305) 265-9220

9350 Sunset Dr
Ste 151
Miami, FL 33173
Phone (786) 548-1022

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1392940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1033534474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9350 SUNSET DR STE 151",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331733286",
            "telephone_number": "786-548-1022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9350 SUNSET DR STE 151",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331733286",
            "telephone_number": "786-548-1022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3436 Marinatown Ln Ste 151",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339037058",
            "country_code": "US",
            "telephone_number": "786-548-1022 x1022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VICENS-FERNANDEZ",
        "first_name": "ELIZABETH",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-21",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH5828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.