Individual provider Active NPI

Kate Vazaios, LMHC

  • Mental Health Counselor
  • Burlingame, CA
National Provider Identifier
1093472474
Registry record updated Mar 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH14383 Issued in FL
Practice address
287 Lorton Ave
Burlingame, CA 94010-4203
Phone
(800) 505-5972
NPI assigned
Nov 20, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2022

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 MH14383 FL Primary

Addresses

Primary practice location

287 Lorton Ave
Burlingame, CA 94010-4203

Mailing address

287 Lorton Ave
Burlingame, CA 94010-4203
Phone (800) 505-5972

Other identifiers 1

IdentifierTypeStateIssuer
NONEOtherFLNONE

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

State licenses

LicenseStateTypeSpecialty
MH14383FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lyra Clinical of New Jersey P.C. CurrentSince Mar 6, 2022 Accepting new patients
Lyra Clinical Associates P.C. PastSince Mar 6, 2022 Accepting new patients

Locations

287 Lorton Ave
Burlingame, CA 94010
Phone (714) 787-7505

Organizations & group practices 2

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": "1637366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646265600000",
    "number": "1093472474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "287 LORTON AVE",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940104203",
            "telephone_number": "800-505-5972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "287 LORTON AVE",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940104203",
            "telephone_number": "800-505-5972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZAIOS",
        "first_name": "KATE",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-20",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH14383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "NONE",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlingame, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2022; 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.