Individual provider Active NPI

Autumn Kathleen Dolan, LMFT

  • Marriage & Family Therapist
  • Hollywood, FL
National Provider Identifier
1396389235
Registry record updated Nov 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MT3448
Practice address
11011 Sheridan St Ste 211
Hollywood, FL 33026-1531
Phone
(954) 951-2929
NPI assigned
Nov 4, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X MT3448 Primary

Addresses

Primary practice location

11011 Sheridan St Ste 211
Hollywood, FL 33026-1531

Mailing address

5240 N Hills Dr
Hollywood, FL 33021-1623
Phone (754) 264-6255

Other practice location 1

5240 N Hills Dr
Hollywood, FL 33021-1623
Phone (754) 264-6255

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

NPI Registry JSON

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

{
    "created_epoch": "1572825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572825600000",
    "number": "1396389235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5240 N HILLS DR",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330211623",
            "telephone_number": "754-264-6255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11011 SHERIDAN ST STE 211",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330261531",
            "telephone_number": "954-951-2929"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5240 N Hills Dr",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "330211623",
            "country_code": "US",
            "telephone_number": "754-264-6255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOLAN",
        "first_name": "AUTUMN",
        "middle_name": "KATHLEEN",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-04",
        "last_updated": "2019-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": "MT3448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2019; 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.