Liderazgo Y Estilo de Vida Transformacional, Inc

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

LIDERAZGO Y ESTILO DE VIDA TRANSFORMACIONAL, INC

Practice address

1604 17TH Ter NE
Winter Haven, FL 33881-4416

Phone

(863) 288-1635

NPI assigned

Sep 24, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Abraham Tirado Ayala, CBHCMNPI 1679146997

Title

Mental Health Care

Phone

(863) 288-1635

Specialties & licenses 8

Addresses

Other names 1

• Liderazgo y Estilo De Vida, Inc Other name

Locations

Practitioners 2

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.

• Abraham Tirado Ayala, CBHCM

  • Addiction (Substance Use Disorder) Counselor
  • Winter Haven, FL
  • NPI 1679146997
  NPD Authorized official
• Daiana Rosado

  • Specialist
  • Haines City, FL
  • NPI 1780206607
  NPD

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

{
    "created_epoch": "1569283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626998400000",
    "number": "1386295095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1604 17TH TER NE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814416",
            "telephone_number": "863-288-1635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1604 17TH TER NE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814416",
            "telephone_number": "863-288-1635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIDERAZGO Y ESTILO DE VIDA TRANSFORMACIONAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-24",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A",
        "authorized_official_last_name": "TIRADO AYALA",
        "authorized_official_first_name": "ABRAHAM",
        "authorized_official_title_or_position": "MENTAL HEALTH CARE",
        "authorized_official_telephone_number": "863-288-1635",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CBHCM"
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282J00000X",
            "taxonomy_group": "",
            "desc": "Religious Nonmedical Health Care Institution",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Liderazgo y Estilo De Vida, Inc",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Liderazgo y Estilo De Vida, Inc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kelli D Lewis-Foltin, PMHNP-BC
• Jami Jordan-McCall Lewis, ARNP
• Kimberly J Lewis, MHC
• O'Kema Shanta Lewis, RN
• Stacy Lewis
• Siam Lieu, PHARMD
• Melissa A. Lievano-Gomes, M.S. SLP
• Life Care Centers of America, Inc. (Life Care Center of Winter Haven)
• Life Changes Counseling and Coaching Services, LLC
• Danny Lim, AA

• Mental Health Clinic/Center (Including Community Mental Health Center) in Winter Haven, FL
• Providers in Winter Haven, FL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2021; 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.