Active NPI
Lifestar Mental Wellness Center Inc, CMHC
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Hialeah Gardens, FL
National Provider Identifier
1568035269
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Legal business name
- LIFESTAR MENTAL WELLNESS CENTER INC, CMHC
- Practice address
- 3414 W 84TH St Ste D110
Hialeah Gardens, FL 33018-4932 - Phone
- (786) 303-5079
- NPI assigned
- Jul 20, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jenny A Bernal, RMHI
- Title
- Ceo
- Phone
- (786) 303-5079
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | |||
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Primary |
Addresses
Primary practice location
3414 W 84TH St Ste D110
Hialeah Gardens, FL 33018-4932
Mailing address
3414 W 84TH St Ste D110
Hialeah, FL 33018-4932
Phone (305) 825-4320
National Provider Directory
National Provider Directory- Tax ID family
- Lifestar Mental Wellness Center Inc CMHC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Behavioral Health Agency
- Hialeah, FL
- NPI 1619313186
Locations
1199 NE 1st Ave
Florida City, FL 33034
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Social Worker
- Hialeah, FL
- NPI 1568563849
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626739200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1721347200000",
"number": "1568035269",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3414 W 84TH ST STE D110",
"city": "HIALEAH",
"state": "FL",
"postal_code": "330184932",
"telephone_number": "305-825-4320"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3414 W 84TH ST STE D110",
"city": "HIALEAH GARDENS",
"state": "FL",
"postal_code": "330184932",
"telephone_number": "786-303-5079"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LIFESTAR MENTAL WELLNESS CENTER INC, CMHC",
"organizational_subpart": "NO",
"enumeration_date": "2021-07-20",
"last_updated": "2024-07-19",
"certification_date": "2024-07-19",
"status": "A",
"authorized_official_last_name": "BERNAL",
"authorized_official_first_name": "JENNY",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "786-303-5079",
"authorized_official_credential": "RMHI"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QM0801X",
"taxonomy_group": "",
"desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hialeah Gardens, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.