Individual provider Active NPI

Lyneida Lizette Lopez-Estrella, LMHC

  • Clinical Social Worker
  • Hollywood, FL
National Provider Identifier
1255910329
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
MH17555 Issued in FL
Practice address
1957 Jackson St
Hollywood, FL 33020-5021
Phone
(954) 921-2600
NPI assigned
Apr 6, 2021
Last updated
Apr 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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 MH17555 FL
Clinical Social Worker 1041C0700X MH17555 FL Primary

Addresses

Primary practice location

1957 Jackson St
Hollywood, FL 33020-5021

Mailing address

4740 N State Road 7
Lauderdale Lakes, FL 33319-5839
Phone (954) 486-4005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240903002147 FL Practitioner - Mental Health Counselor 5294274312 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH17555FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Henderson Behavioral Health, Inc. CurrentSince Aug 2, 2024 Accepting new patients
Henderson Behavioral Health, Inc. PastSince Apr 11, 2021 Accepting new patients

Locations

330 SW 27th Ave
Ft Lauderdale, FL 33312
Phone (954) 463-0911

1957 Jackson St
Hollywood, FL 33020
Phone (954) 791-4300

3347 N University Dr
Hollywood, FL 33024
Phone (954) 587-7880

4740 N State Road 7
Ste 201
Lauderdale Lakes, FL 33319
Phone (954) 497-3850

Organizations & group practices 2

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": "1617667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1255910329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4740 N STATE ROAD 7",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333195839",
            "telephone_number": "954-486-4005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1957 JACKSON ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330205021",
            "telephone_number": "954-921-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ-ESTRELLA",
        "first_name": "LYNEIDA",
        "middle_name": "LIZETTE",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-06",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH17555",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "MH17555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.