Individual provider Active NPI

Williams Jose Lucena, MENTAL HEALTH COUNSE

  • Mental Health Counselor
  • Miami, FL
National Provider Identifier
1114188588
Registry record updated Feb 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH 8062 Issued in FL
Practice address
200 SE 15TH Rd PH a
Miami, FL 33129-1201
Phone
(305) 778-6795
NPI assigned
Jun 19, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 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 MH 8062 FL Primary

Addresses

Primary practice location

200 SE 15TH Rd PH a
Miami, FL 33129-1201

Mailing address

200 SE 15TH Rd PH a
Miami, FL 33129-1201
Phone (305) 778-6795

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
I20251114000011 FL Practitioner - Mental Health Counselor 1052338167 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1995
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1801 Coral Way
Suite 327
Miami, FL 33145-2784

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH 8062FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Brain & Behavioral Institute of South Florida Inc Mental Health CurrentSince Jan 1, 2021 Accepting new patients
Miami Lakes Doctor'S LLC PastSince Jul 25, 2021 Accepting new patients

Locations

1801 Coral Way
Ste 327
Miami, FL 33145
Phone (786) 866-5914

1801 SW 22nd St
Ste 405
Miami, FL 33145
Phone (305) 854-9023

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": "1213833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1114188588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 SE 15TH RD PH A",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331291201",
            "telephone_number": "305-778-6795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SE 15TH RD PH A",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331291201",
            "telephone_number": "305-778-6795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCENA",
        "first_name": "WILLIAMS",
        "middle_name": "JOSE",
        "credential": "MENTAL HEALTH COUNSE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-19",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 8062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.