Active NPI
Susana Tamez
- Mental Health Counselor
- Clewiston, FL
National Provider Identifier
1275264970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- IMH22402
- Practice address
- 516 San Luiz Ave
Clewiston, FL 33440-0257 - Phone
- (863) 233-8491
- NPI assigned
- Jun 22, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | IMH22402 | FL | Primary |
Addresses
Primary practice location
516 San Luiz Ave
Clewiston, FL 33440-0257
Mailing address
516 San Luiz Ave
Clewiston, FL 33440-0257
Phone (863) 233-8491
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 |
|---|---|---|---|
| IMH22402 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655856000000",
"number": "1275264970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "516 SAN LUIZ AVE",
"city": "CLEWISTON",
"state": "FL",
"postal_code": "334400257",
"telephone_number": "863-233-8491"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "516 SAN LUIZ AVE",
"city": "CLEWISTON",
"state": "FL",
"postal_code": "334400257",
"telephone_number": "863-233-8491"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAMEZ",
"first_name": "SUSANA",
"name_prefix": "Miss",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-06-22",
"last_updated": "2022-06-22",
"certification_date": "2022-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "IMH22402",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clewiston, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.