Individual provider Active NPI

Lisa Amarilys Hernandez, LMHC

  • Mental Health Counselor
  • Davie, FL
National Provider Identifier
1245957679
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
IMH20206 Issued in FL
Practice address
5400 S University Dr Ste 308
Davie, FL 33328-5310
Phone
(954) 378-5381
NPI assigned
Oct 26, 2022
Last updated
Aug 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X IMH20206 FL Primary

Addresses

Primary practice location

5400 S University Dr Ste 308
Davie, FL 33328-5310

Mailing address

420 S Park Rd Apt 306
Hollywood, FL 33021-8728
Phone (954) 665-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Feb 23, 2024 through Feb 23, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
IMH20206FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Amanda Patterson, LMHC, LLC Mental Health CurrentSince Dec 10, 2023 Accepting new patients

Locations

5400 S University Dr
Ste 308
Davie, FL 33328
Phone (954) 665-1200

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": "1666742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1245957679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 S PARK RD APT 306",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330218728",
            "telephone_number": "954-665-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 S UNIVERSITY DR STE 308",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333285310",
            "telephone_number": "954-378-5381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "LISA",
        "middle_name": "AMARILYS",
        "name_prefix": "Ms.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-26",
        "last_updated": "2023-08-07",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH20206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

Verify at the official NPI Registry.