Individual provider Active NPI

Lakeisha Staten, LPC

  • Mental Health Counselor
  • Kissimmee, FL
National Provider Identifier
1225717184
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C.2405867 Issued in OH
Practice address
741 Cockatoo CT
Kissimmee, FL 34759-4510
Phone
(843) 910-6314
NPI assigned
Jul 17, 2023
Last updated
Mar 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 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 C.2405867 OH Primary
Case Manager/Care Coordinator 171M00000X NU

Addresses

Primary practice location

741 Cockatoo CT
Kissimmee, FL 34759-4510

Mailing address

741 Cockatoo CT
Kissimmee, FL 34759-4510

Other practice location 1

500 Madison Ave Ste 200
Toledo, OH 43604-1230
Phone (567) 312-8700

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
C.2405867OHMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1689552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1225717184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 COCKATOO CT",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347594510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 COCKATOO CT",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347594510",
            "telephone_number": "843-910-6314"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Madison Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436041230",
            "country_code": "US",
            "telephone_number": "567-312-8700",
            "fax_number": "512-312-8793",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STATEN",
        "first_name": "LAKEISHA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-17",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.2405867",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.