Individual provider Active NPI

Maylin Gonzalez, M.S

  • Mental Health Counselor
  • Hollywood, FL
National Provider Identifier
1609390426
Registry record updated Jan 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH17371 Issued in FL
Practice address
9900 Stirling Rd Ste 103
Hollywood, FL 33024-8073
Phone
(954) 300-2921
Fax
(954) 529-2001
NPI assigned
Aug 2, 2017
Last updated
Jan 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH17371 FL Primary
Mental Health Counselor 101YM0800X 16392 FL
Developmental Therapist 222Q00000X
Early Intervention Provider Agency 252Y00000X

Addresses

Primary practice location

9900 Stirling Rd Ste 103
Hollywood, FL 33024-8073

Mailing address

330 W 46TH St
Hialeah, FL 33012-3947
Phone (786) 365-6235

Other practice location 1

4649 Ponce De Leon Blvd Ste 404
Coral Gables, FL 33146-2121
Phone (786) 536-9714

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
I20240125000822 FL Practitioner - Mental Health Counselor 7012360142 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
16392FLMDMental Health Counselor
MH17371FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Abcs for Success, LLC CurrentSince Jun 1, 2020 Accepting new patients
Grow Healthcare Group PA Mental Health CurrentSince Jan 23, 2024 Accepting new patients
Stellar Health Services, LLC CurrentSince Jan 1, 2024 Accepting new patients
Shine Medical Providers PC Past Accepting new patients

Locations

1550 Madruga Ave
Ste 509
Coral Gables, FL 33146
Phone (305) 662-9805

1550 S Dixie Hwy
Ste 203
Coral Gables, FL 33146
Phone (305) 666-3824

4649 Ponce de Leon Blvd
Ste 404
Coral Gables, FL 33146

9900 Stirling Rd
Ste 103
Hollywood, FL 33024
Phone (954) 300-2921

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Networks

  • Freedom Health HMO Network

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1501632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1609390426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 W 46TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330123947",
            "telephone_number": "786-365-6235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 STIRLING RD STE 103",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330248073",
            "telephone_number": "954-300-2921",
            "fax_number": "954-529-2001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4649 Ponce De Leon Blvd Ste 404",
            "address_purpose": "LOCATION",
            "city": "Coral Gables",
            "state": "FL",
            "postal_code": "331462121",
            "country_code": "US",
            "telephone_number": "786-536-9714",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "MAYLIN",
        "credential": "M.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-02",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH17371",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "16392",
            "primary": false
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.