Active NPI
Lyndere M Persaud
- Counselor
- Miramar, FL
National Provider Identifier
1245033067
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- ISW15917
- Practice address
- 16724 SW 36TH CT
Miramar, FL 33027-4554 - Phone
- (954) 205-2112
- NPI assigned
- Mar 28, 2025
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | ISW15917 | FL | |
| Counselor | 101Y00000X | ISW15917 | FL | Primary |
Addresses
Primary practice location
16724 SW 36TH CT
Miramar, FL 33027-4554
Mailing address
16724 SW 36TH CT
Miramar, FL 33027-4554
Phone (954) 205-2112
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
| License | State | Type | Specialty |
|---|---|---|---|
| ISW15917 | FL | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1743120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743120000000",
"number": "1245033067",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16724 SW 36TH CT",
"city": "MIRAMAR",
"state": "FL",
"postal_code": "330274554",
"telephone_number": "954-205-2112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16724 SW 36TH CT",
"city": "MIRAMAR",
"state": "FL",
"postal_code": "330274554",
"telephone_number": "954-205-2112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERSAUD",
"first_name": "LYNDERE",
"middle_name": "M",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-03-28",
"last_updated": "2025-03-28",
"certification_date": "2025-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "ISW15917",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "FL",
"license": "ISW15917",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miramar, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.