Indenpendent Contractor for Counseling Services

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH4860 Issued in FL

Legal business name

INDENPENDENT CONTRACTOR FOR COUNSELING SERVICES

Practice address

1606 Tennessee Ave
Lynn Haven, FL 32444-3653

Phone

(850) 814-5060

Fax

(850) 265-1811

NPI assigned

Apr 16, 2015

Last updated

Apr 16, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Lourdes M. Sanchez-Rodriguez, LMHCNPI 1639278435

Title

Owner/Sole Proprietator

Phone

(850) 814-5060

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lourdes M. Sanchez-Rodriguez, LMHC

  • Mental Health Counselor
  • Lynn Haven, FL
  • NPI 1639278435
  NPD (past) Authorized official

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

{
    "created_epoch": "1429142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429142400000",
    "number": "1205223328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 SOMMER CIR",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324053224",
            "telephone_number": "850-814-5060",
            "fax_number": "850-265-1811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1606 TENNESSEE AVE",
            "city": "LYNN HAVEN",
            "state": "FL",
            "postal_code": "324443653",
            "telephone_number": "850-814-5060",
            "fax_number": "850-265-1811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDENPENDENT CONTRACTOR FOR COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-16",
        "last_updated": "2015-04-16",
        "status": "A",
        "authorized_official_last_name": "SANCHEZ-RODRIGUEZ",
        "authorized_official_first_name": "LOURDES",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER/SOLE PROPRIETATOR",
        "authorized_official_telephone_number": "850-814-5060",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH4860",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "763657100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID- DEVELOPMENTAL SPECIALIST",
            "identifier": "811551600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Lynn Haven, FL
• Providers in Lynn Haven, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2015; 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.