Lizzette Mambru, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MT3554 Issued in FL

Practice address

12773 Forest Hill Blvd Ste 1211
Wellington, FL 33414-4760

Phone

(561) 308-3465

NPI assigned

Aug 10, 2018

Last updated

Sep 9, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 22, 2024 through Feb 22, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1533859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1255810198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12773 FOREST HILL BLVD STE 1211",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334144760",
            "telephone_number": "561-308-3465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12773 FOREST HILL BLVD STE 1211",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334144760",
            "telephone_number": "561-308-3465"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4101 Parker Ave",
            "address_purpose": "LOCATION",
            "city": "West Palm Beach",
            "state": "FL",
            "postal_code": "334052507",
            "country_code": "US",
            "telephone_number": "561-308-3465",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAMBRU",
        "first_name": "LIZZETTE",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-10",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT3554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adam Mandel, M.D.
• Maria Manuel
• Marc S Flesher O.D. P.a. (Eye-Site Optical Wellington)

• Marriage & Family Therapist in Wellington, FL
• Providers in Wellington, FL by specialty
• Marriage & Family Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.