NPIMap

Organization Active NPI

Advanced Mental Health Clinic Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Miami, FL
National Provider Identifier
1285676494
Registry record updated Sep 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
101490 Issued in FL
Legal business name
ADVANCED MENTAL HEALTH CLINIC INC
Practice address
13055 SW 42ND St Ste 104
Miami, FL 33175-3470
Phone
(305) 480-7839
Fax
(305) 480-7892
NPI assigned
Jun 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2020

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

Authorized official

Name
Ms. Lucia Carreno
Title
President/Administrator
Phone
(305) 480-7839

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 101490 FL Primary

Addresses

Primary practice location

13055 SW 42ND St Ste 104
Miami, FL 33175-3470

Mailing address

13055 SW 42ND St Ste 104
Miami, FL 33175-3470

Other identifiers 1

IdentifierTypeStateIssuer
EO918AOtherFLMEDICARE PART B

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110308000345 FL Part B Supplier - Clinic/Group Practice 7911924048 Receives reassigned benefits from 2 practitioners
Practice locations: Miami, FL

National Provider Directory

National Provider Directory

Locations

13780 SW 26th St
Ste 107
Miami, FL 33175
Phone (305) 480-7839

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598918400000",
    "number": "1285676494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13055 SW 42ND ST STE 104",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331753470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13055 SW 42ND ST STE 104",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331753470",
            "telephone_number": "305-480-7839",
            "fax_number": "305-480-7892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED MENTAL HEALTH CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A",
        "authorized_official_last_name": "CARRENO",
        "authorized_official_first_name": "LUCIA",
        "authorized_official_title_or_position": "PRESIDENT/ADMINISTRATOR",
        "authorized_official_telephone_number": "305-480-7839",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "FL",
            "license": "101490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "EO918A",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.