Lifeguide, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

LIFEGUIDE, LLC

Doing business as

Lifeguide, LLC

Practice address

1416 NE 5TH CT Apt 4
Fort Lauderdale, FL 33301-1272

Phone

(850) 345-8732

NPI assigned

Apr 26, 2021

Organization subpart

No

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

Authorized official

Name

Olushola A LawalNPI 1720453715

Title

Ceo

Phone

(850) 345-8732

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lifeguide, LLC Doing business as

Electronic endpoints 1

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Lifeguide Healing, LLC.

  dba Mental Minute Kare

  • Developmentally Disabled Services Day Training Agency
  • Tallahassee, FL
  • NPI 1952219008
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Olushola Lawal, MSW

  • Clinical Social Worker
  • Minneapolis, MN
  • NPI 1720453715
  NPD Authorized official

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

{
    "created_epoch": "1619395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619395200000",
    "number": "1073195483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1416 NE 5TH CT APT 4",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333011272",
            "telephone_number": "850-345-8732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1416 NE 5TH CT APT 4",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333011272",
            "telephone_number": "850-345-8732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEGUIDE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-26",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A",
        "authorized_official_last_name": "LAWAL",
        "authorized_official_first_name": "OLUSHOLA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "850-345-8732"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "834950",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "desktop",
            "affiliation": "Y",
            "endpointDescription": "desktop",
            "affiliationName": "Lifeguide, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1416 NE 5th Ct Apt 4",
            "city": "Fort Lauderdale",
            "state": "FL",
            "country_code": "US",
            "postal_code": "333011272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Lifeguide, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Mental Health Counselor in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2021; 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.