M.Fernanda Therapy PLLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

M.FERNANDA THERAPY PLLC

Practice address

1413 S Disston Ave
Tarpon Springs, FL 34689-7911

Phone

(617) 840-1742

NPI assigned

Aug 22, 2024

Organization subpart

No

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

Authorized official

Name

Maria Fernanda Gallegos, LMHCNPI 1700412293

Title

Owner

Phone

(617) 840-1742

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Maria Fernanda Gallegos, LCPC

  • Mental Health Counselor
  • Chicago, IL
  • NPI 1700412293
  NPD Authorized official

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

{
    "created_epoch": "1724284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724284800000",
    "number": "1356174536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1413 S DISSTON AVE",
            "city": "TARPON SPRINGS",
            "state": "FL",
            "postal_code": "346897911",
            "telephone_number": "617-840-1742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1413 S DISSTON AVE",
            "city": "TARPON SPRINGS",
            "state": "FL",
            "postal_code": "346897911",
            "telephone_number": "617-840-1742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M.FERNANDA THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-22",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A",
        "authorized_official_last_name": "GALLEGOS",
        "authorized_official_first_name": "MARIA FERNANDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-840-1742",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• LP Tarpon Springs LLC (Peninsula Care & Rehabilitation Center)
• Erin Heise Luecke, MPT
• Jonathan Lugo, BCBA
• Charles Lwin, PTA
• Jolanta M M Kuczek, PHARMD
• M&M Health Holdings (Mind and Mobility)
• Jacobson Ma, D.M.D.
• George Patrick Macris, MD
• Logan Magoulis
• James Matthew Maister, R.PH.

• Adult Mental Health Clinic/Center in Tarpon Springs, FL
• Providers in Tarpon Springs, FL by specialty
• Adult Mental Health Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; 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.