Active NPI
Lawrence Wiliam Reidt, LMFT
- Marriage & Family Therapist
- Lecanto, FL
National Provider Identifier
1265891717
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MT3122
- Practice address
- 2417 N Lecanto Hwy
Lecanto, FL 34461-9677 - Phone
- (352) 270-9009
- NPI assigned
- Feb 12, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MT3122 | FL | Primary |
Addresses
Primary practice location
2417 N Lecanto Hwy
Lecanto, FL 34461-9677
Mailing address
PO Box 491000
Leesburg, FL 34749-1000
Phone (352) 315-7500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 101901300 | Medicaid | FL |
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 |
|---|---|---|---|
| MT3122 | FL | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifestream Behavioral Center Inc | Past | Accepting new patients | |
| Lifestream Behavioral Center Inc | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Primary Care Clinic/Center
- Leesburg, FL
- NPI 1659613776
-
- Psychiatric Hospital
- Leesburg, FL
- NPI 1902802002
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1455235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550448000000",
"number": "1265891717",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 491000",
"city": "LEESBURG",
"state": "FL",
"postal_code": "347491000",
"telephone_number": "352-315-7500",
"fax_number": "352-315-7587"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2417 N LECANTO HWY",
"city": "LECANTO",
"state": "FL",
"postal_code": "344619677",
"telephone_number": "352-270-9009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REIDT",
"first_name": "LAWRENCE",
"middle_name": "WILIAM",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-02-12",
"last_updated": "2019-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "FL",
"license": "MT3122",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "101901300",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lecanto, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.