Active NPI
Hubert Faustin, MS.
- Marriage & Family Therapist
- Fort Lauderdale, FL
National Provider Identifier
1548712524
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- IMT2079
- Practice address
- 1409 NW 1St Avenue
Fort Lauderdale, FL 33311 - Phone
- (954) 200-3546
- NPI assigned
- Oct 26, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | IMT2079 | FL | |
| Marriage & Family Therapist | 106H00000X | IMT2079 | FL | Primary |
Addresses
Primary practice location
1409 NW 1St Avenue
Fort Lauderdale, FL 33311
Mailing address
1409 NW 1St Avenue
Fort Lauderdale, FL 33311
Phone (954) 200-3546
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| IMT2079 | Medicaid | FL |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMT2079 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1477440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477440000000",
"number": "1548712524",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1409 NW 1ST AVENUE",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "33311",
"telephone_number": "954-200-3546"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1409 NW 1ST AVENUE",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "33311",
"telephone_number": "954-200-3546"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAUSTIN",
"first_name": "HUBERT",
"credential": "MS.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-10-26",
"last_updated": "2016-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "IMT2079",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "FL",
"license": "IMT2079",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "IMT2079",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Lauderdale, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.