Organization Active NPI

Lifeline Counseling Center, Inc

  • Mental Health Counselor
  • Coral Springs, FL
National Provider Identifier
1285872879
Registry record updated Jun 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
LIFELINE COUNSELING CENTER, INC
Practice address
5571 N University Dr #101
Coral Springs, FL 33067
Phone
(954) 544-4991
Fax
(954) 544-4992
NPI assigned
Feb 4, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2022

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

Authorized official

Name
Jacqueline Marie Cagney, LMFTNPI 1225026644
Title
Owner
Phone
(954) 544-4992

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X MH2618 FL
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X Primary
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X SW8336 FL
Marriage & Family TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 106H00000X MT1579 FL

Addresses

Primary practice location

5571 N University Dr #101
Coral Springs, FL 33067

Mailing address

5571 N University Dr #101
Coral Springs, FL 33067
Phone (954) 544-4991

Other identifiers 1

IdentifierTypeStateIssuer
MT1579OtherFLFLORIDA LICENSE NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240126002537 FL Part B Supplier - Clinic/Group Practice 9032562921 Receives reassigned benefits from 1 practitioner
Practice locations: Coral Springs, FL

National Provider Directory

National Provider Directory
Tax ID family
Lifeline Counseling Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1233705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656374400000",
    "number": "1285872879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5571 N UNIVERSITY DR #101",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "33067",
            "telephone_number": "954-544-4991",
            "fax_number": "954-544-4992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5571 N UNIVERSITY DR #101",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "33067",
            "telephone_number": "954-544-4991",
            "fax_number": "954-544-4992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFELINE COUNSELING CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-04",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A",
        "authorized_official_last_name": "CAGNEY",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-544-4992",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH2618",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW8336",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT1579",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA LICENSE NUMBER",
            "identifier": "MT1579",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; 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.