Individual provider Active NPI

Carlos Enrique Mendez, LMHC

  • Mental Health Counselor
  • Fort Lauderdale, FL
National Provider Identifier
1124638408
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH20832 Issued in FL
Practice address
2900 W Prospect Rd
Fort Lauderdale, FL 33309-2519
Phone
(954) 731-5100
NPI assigned
Aug 3, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X IMH17157 FL
Mental Health Counselor 101YM0800X MH20832 FL Primary

Addresses

Primary practice location

2900 W Prospect Rd
Fort Lauderdale, FL 33309-2519

Mailing address

4740 N State Road 7 Ste 201
Lauderdale Lakes, FL 33319-5839

Other practice location 1

7511 Sheridan St
Hollywood, FL 33024-2637
Phone (954) 662-5679

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
IMH17157FLMDMental Health Counselor
MH20832FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1596412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1124638408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4740 N STATE ROAD 7 STE 201",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333195839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 W PROSPECT RD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333092519",
            "telephone_number": "954-731-5100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7511 Sheridan St",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "330242637",
            "country_code": "US",
            "telephone_number": "954-662-5679",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENDEZ",
        "first_name": "CARLOS",
        "middle_name": "ENRIQUE",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-03",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH17157",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH20832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; 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.