Active NPI
Lillian M Sardina, MS, ICS, CSAC, LPC
- Mental Health Counselor
- Milwaukee, WI
National Provider Identifier
1205009354
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 7502-125
- Practice address
- 930 W Historic Mitchell St
Milwaukee, WI 53204-3533 - Phone
- (414) 383-9526
- Fax
- (414) 671-6606
- NPI assigned
- Apr 9, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1965-132 | WI | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 11226-135 | WI | |
| Mental Health Counselor | 101YM0800X | 7502-125 | WI | Primary |
Addresses
Primary practice location
930 W Historic Mitchell St
Milwaukee, WI 53204-3533
Mailing address
930 W Mitchell St
Milwaukee, WI 53204-3533
Phone (414) 383-9526
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 39362500 | Medicaid | WI |
Other names 1
- Lillian M Benavides
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11226-135 | WI | MD | Addiction (Substance Use Disorder) Counselor |
| 1965-132 | WI | MD | Addiction (Substance Use Disorder) Counselor |
| 7502-125 | WI | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583193600000",
"number": "1205009354",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "930 W MITCHELL ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532043533",
"telephone_number": "414-383-9526",
"fax_number": "414-229-2912"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "930 W HISTORIC MITCHELL ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532043533",
"telephone_number": "414-383-9526",
"fax_number": "414-671-6606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SARDINA",
"first_name": "LILLIAN",
"middle_name": "M",
"credential": "MS, ICS, CSAC, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-04-09",
"last_updated": "2020-03-03",
"certification_date": "2020-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WI",
"license": "1965-132",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WI",
"license": "11226-135",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WI",
"license": "7502-125",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "39362500",
"state": "WI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LILLIAN",
"last_name": "BENAVIDES",
"middle_name": "M",
"credential": "CADAC, CI",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.