Individual provider Active NPI

Gladys Blumenstine

  • Mental Health Counselor
  • Fort Lauderdale, FL
National Provider Identifier
1295052660
Registry record updated Apr 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH10273 Issued in FL
Practice address
2699 Stirling Rd
Suite B304
Fort Lauderdale, FL 33312-6517
Phone
(786) 797-0759
NPI assigned
Apr 26, 2010
Last updated
Apr 26, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH10273 FL Primary

Addresses

Primary practice location

2699 Stirling Rd
Suite B304
Fort Lauderdale, FL 33312-6517

Mailing address

2699 Stirling Rd
Suite B304
Fort Lauderdale, FL 33312-6517
Phone (786) 797-0759

Other names 1

  • Gladys Braga Evangelista Former name

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
MH10273FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1272240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272240000000",
    "number": "1295052660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2699 STIRLING RD",
            "address_2": "SUITE B304",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333126517",
            "telephone_number": "786-797-0759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2699 STIRLING RD",
            "address_2": "SUITE B304",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333126517",
            "telephone_number": "786-797-0759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUMENSTINE",
        "first_name": "GLADYS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-26",
        "last_updated": "2010-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH10273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GLADYS",
            "last_name": "EVANGELISTA",
            "middle_name": "BRAGA",
            "credential": "LMHC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2010; 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.