Individual provider Active NPI

Lidice Davila

  • Mental Health Counselor
  • Orlando, FL
National Provider Identifier
1417610759
Registry record updated Oct 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
7041 Grand National Dr Ste 200
Orlando, FL 32819-8380
Phone
(407) 982-7718
Fax
(407) 704-5953
NPI assigned
Oct 13, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2021

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 Primary

Addresses

Primary practice location

7041 Grand National Dr Ste 200
Orlando, FL 32819-8380

Mailing address

2016 Bearing LN
Kissimmee, FL 34744-5921
Phone (407) 924-8184

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": "1634083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634083200000",
    "number": "1417610759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2016 BEARING LN",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347445921",
            "telephone_number": "407-924-8184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7041 GRAND NATIONAL DR STE 200",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328198380",
            "telephone_number": "407-982-7718",
            "fax_number": "407-704-5953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVILA",
        "first_name": "LIDICE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-13",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.