Individual provider Active NPI

Faith Monica Bird, EDD, LMHC, CAP

  • Mental Health Counselor
  • Plantation, FL
National Provider Identifier
1215073986
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH 7548 Issued in FL
Practice address
1876 N University Dr
Suite 200-C
Plantation, FL 33322-4130
Phone
(954) 472-2377
Fax
(954) 888-1744
NPI assigned
Jan 30, 2007
Last updated
Oct 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CAP 2012 FL
Mental Health Counselor 101YM0800X MH 7548 FL Primary

Addresses

Primary practice location

1876 N University Dr
Suite 200-C
Plantation, FL 33322-4130

Mailing address

1876 N University Dr
Suite 200-C
Plantation, FL 33322-4130
Phone (954) 472-2377

Other identifiers 1

IdentifierTypeStateIssuer
270104313OtherFLTAX IDENTIFICATION NUMBER

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
CAP 2012FLMDAddiction (Substance Use Disorder) Counselor
MH 7548FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Peacock Industries Counseling & Research Services, Inc Mental Health Past Accepting new patients

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": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1215073986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1876 N UNIVERSITY DR",
            "address_2": "SUITE 200-C",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333224130",
            "telephone_number": "954-472-2377",
            "fax_number": "954-888-1744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1876 N UNIVERSITY DR",
            "address_2": "SUITE 200-C",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333224130",
            "telephone_number": "954-472-2377",
            "fax_number": "954-888-1744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRD",
        "first_name": "FAITH",
        "middle_name": "MONICA",
        "name_prefix": "Dr.",
        "credential": "EDD, LMHC, CAP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "CAP 2012",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 7548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION NUMBER",
            "identifier": "270104313",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; 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.