Active NPI
Robin Siebold
- Mental Health Counselor
- Lake Mary, FL
National Provider Identifier
1366055592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MH3038
- Practice address
- 801 International Pkwy Ste 500
Lake Mary, FL 32746-4763 - Phone
- (407) 765-9379
- NPI assigned
- Aug 27, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MH3038 | FL | Primary |
Addresses
Primary practice location
801 International Pkwy Ste 500
Lake Mary, FL 32746-4763
Mailing address
PO Box 951338
Lake Mary, FL 32795-1338
Phone (407) 765-9379
Other practice location 1
3270 Suntree Blvd
Melbourne, FL 32940-7530
Phone (321) 543-9695
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 1988
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
66 E Flagler St
Miami, FL 33130-1807
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MH3038 | FL | MD | Mental Health Counselor |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Health Counselor
- Miami, FL
- NPI 1245845932
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598486400000",
"number": "1366055592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 951338",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "327951338",
"telephone_number": "407-765-9379"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 INTERNATIONAL PKWY STE 500",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "327464763",
"telephone_number": "407-765-9379"
}
],
"practiceLocations": [
{
"address_1": "3270 Suntree Blvd",
"address_purpose": "LOCATION",
"city": "Melbourne",
"state": "FL",
"postal_code": "329407530",
"country_code": "US",
"telephone_number": "321-543-9695",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SIEBOLD",
"first_name": "ROBIN",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-08-27",
"last_updated": "2020-08-27",
"certification_date": "2020-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH3038",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Mary, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.