Individual provider Active NPI

Linda Fiesta, LCPC

  • Mental Health Counselor
  • Annapolis, MD
National Provider Identifier
1417420407
Registry record updated Jan 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LC7804 Issued in MD
Practice address
104 Forbes St Ste 205
Annapolis, MD 21401-1598
Phone
(443) 604-1681
NPI assigned
Jan 2, 2019
Last updated
Jan 2, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2019

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 LC7804 MD Primary

Addresses

Primary practice location

104 Forbes St Ste 205
Annapolis, MD 21401-1598

Mailing address

816 Chester Ave
Annapolis, MD 21403-3230
Phone (443) 604-1681

Other identifiers 1

IdentifierTypeStateIssuer
LC7804OtherMDLICENSURE

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
LC7804MDMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1546387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546387200000",
    "number": "1417420407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 CHESTER AVE",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214033230",
            "telephone_number": "443-604-1681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 FORBES ST STE 205",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214011598",
            "telephone_number": "443-604-1681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIESTA",
        "first_name": "LINDA",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-02",
        "last_updated": "2019-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC7804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSURE",
            "identifier": "LC7804",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 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.