Active NPI
Marie Visalli
- Mental Health Counselor
- Fort Lauderdale, FL
National Provider Identifier
1629122247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 2700 W Cypress Creek Rd
Fort Lauderdale, FL 33309-1744 - Phone
- (954) 514-7569
- Fax
- (954) 514-7569
- NPI assigned
- Jan 22, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
2700 W Cypress Creek Rd
Fort Lauderdale, FL 33309-1744
Mailing address
2700 W Cypress Creek Rd
Fort Lauderdale, FL 33309-1744
Phone (954) 514-7569
Other practice location 1
819 NE 26th St
Wilton Manors, FL 33305-1239
Phone (954) 390-7654 ext. 1248
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 762320800 | 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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708732800000",
"number": "1629122247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2700 W CYPRESS CREEK RD",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333091744",
"telephone_number": "954-514-7569"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2700 W CYPRESS CREEK RD",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333091744",
"telephone_number": "954-514-7569",
"fax_number": "954-514-7569"
}
],
"practiceLocations": [
{
"address_1": "819 NE 26th St",
"address_purpose": "LOCATION",
"city": "Wilton Manors",
"state": "FL",
"postal_code": "333051239",
"country_code": "US",
"telephone_number": "954-390-7654 x1248",
"fax_number": "954-567-5625",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VISALLI",
"first_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-22",
"last_updated": "2024-02-24",
"certification_date": "2024-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "762320800",
"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 Feb 24, 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.