Individual provider Active NPI

Kimberly Sorondo, LMHC

  • Mental Health Counselor
  • Deerfield Beach, FL
National Provider Identifier
1558823799
Registry record updated Apr 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH15082 Issued in FL
Practice address
504 S Federal Hwy
Deerfield Beach, FL 33441-4112
Phone
(954) 505-5357
Fax
(424) 298-4323
NPI assigned
Apr 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 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 MH15082 FL Primary

Addresses

Primary practice location

504 S Federal Hwy
Deerfield Beach, FL 33441-4112

Mailing address

530 S Federal Hwy
Deerfield Beach, FL 33441-4140
Phone (954) 505-5357

Other identifiers 1

IdentifierTypeStateIssuer
MH15082OtherFLSTATE LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ksorondo@fherehab.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260501003121 FL Practitioner - Mental Health Counselor 4587132154 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
One Stop Psychiatry LLCGroup PAC ID 8426435470, 4 clinicians

Practice addresses (Care Compare)

3015 N Ocean Blvd
Suite C101
Fort Lauderdale, FL 33308-7300
Phone (754) 270-6322

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH15082FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Deerfield Florida House, Inc PastSince Jul 31, 2022 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1554422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554422400000",
    "number": "1558823799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 S FEDERAL HWY",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334414140",
            "telephone_number": "954-505-5357",
            "fax_number": "424-298-4323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 S FEDERAL HWY",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334414112",
            "telephone_number": "954-505-5357",
            "fax_number": "424-298-4323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORONDO",
        "first_name": "KIMBERLY",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-05",
        "last_updated": "2019-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH15082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "MH15082",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ksorondo@fherehab.com",
            "affiliation": "N",
            "address_1": "504 S Federal Hwy",
            "city": "Deerfield Beach",
            "state": "FL",
            "country_code": "US",
            "postal_code": "334414112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Deerfield Beach, FL

Sources for this page

Verify at the official NPI Registry.