Individual provider Active NPI

Andrea Donoghue, LCPC, LMHC, MAC

  • Professional Counselor
  • Deerfield Beach, FL
National Provider Identifier
1285790766
Registry record updated Jul 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
178002931 Issued in IL
Practice address
236 NW 41St Ave
Deerfield Beach, FL 33442-8045
Phone
(954) 427-7167
NPI assigned
Dec 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2015

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 39000971A IN
Professional Counselor 101YP2500X 178002931 IL Primary

Addresses

Primary practice location

236 NW 41St Ave
Deerfield Beach, FL 33442-8045

Mailing address

236 NW 41St Ave
Deerfield Beach, FL 33442-8045
Phone (954) 427-7167

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

LicenseStateTypeSpecialty
39000971AINMDMental Health Counselor
178002931ILMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436400000000",
    "number": "1285790766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 NW 41ST AVE",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334428045",
            "telephone_number": "954-427-7167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 NW 41ST AVE",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334428045",
            "telephone_number": "954-427-7167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONOGHUE",
        "first_name": "ANDREA",
        "credential": "LCPC, LMHC, MAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2015-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39000971A",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178002931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deerfield Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.