Individual provider Active NPI

Nicole Alyassa Taylor, MS

  • Mental Health Counselor
  • Miami, FL
National Provider Identifier
1184633224
Registry record updated Nov 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH 8216 Issued in FL
Practice address
99 NW 183Rd St
Miami, FL 33169-4502
Phone
(305) 652-2874
Fax
(305) 652-8528
NPI assigned
Aug 7, 2006
Last updated
Nov 19, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2008

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 8216 FL Primary

Addresses

Primary practice location

99 NW 183Rd St
Miami, FL 33169-4502

Mailing address

1250 SW 27TH Ave
Suite 402
Miami, FL 33135-4741
Phone (305) 398-6100

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
I20240724000038 FL Practitioner - Mental Health Counselor 6305290099 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
MH 8216FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Elevated Society, Inc CurrentSince Oct 12, 2016 Accepting new patients

Locations

20295 NW 2nd Ave
Ste 110
Miami Gardens, FL 33169
Phone (305) 974-4426

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": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227052800000",
    "number": "1184633224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 SW 27TH AVE",
            "address_2": "SUITE 402",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331354741",
            "telephone_number": "305-398-6100",
            "fax_number": "305-757-4465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 NW 183RD ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331694502",
            "telephone_number": "305-652-2874",
            "fax_number": "305-652-8528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "NICOLE",
        "middle_name": "ALYASSA",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-07",
        "last_updated": "2008-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 8216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.