Individual provider Active NPI

Lillianis Jalieris Cruz, LMHC

  • Mental Health Counselor
  • Kissimmee, FL
National Provider Identifier
1629474747
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH14082 Issued in FL
Practice address
241 Ruby Ave Ste B
Kissimmee, FL 34741-5627
Phone
(407) 978-0432
NPI assigned
Nov 17, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

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 MH14082 FL Primary

Addresses

Primary practice location

241 Ruby Ave Ste B
Kissimmee, FL 34741-5627

Mailing address

241 Ruby Ave Ste B
Kissimmee, FL 34741-5627
Phone (407) 978-0432

Other identifiers 1

IdentifierTypeStateIssuer
016903800MedicaidFL

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

State licenses

LicenseStateTypeSpecialty
MH14082FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Hope Counseling of Central FL, LLC CurrentSince Jul 2, 2023 Accepting new patients
Teladoc Health Medical Group, P.a. Mental Health Current Accepting new patients

Locations

241 Ruby Ave
Ste B
Kissimmee, FL 34741
Phone (321) 250-3811

241 Ruby Ave
Unit 213
Kissimmee, FL 34741
Phone (407) 906-5214

907 Emmett St
Kissimmee, FL 34741

Interoperability endpoints

  • Direct secure messaging: lillianiscruz@tdh.allscriptsdirect.net

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, 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": "1416182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1629474747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 RUBY AVE STE B",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347415627",
            "telephone_number": "407-978-0432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 RUBY AVE STE B",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347415627",
            "telephone_number": "407-978-0432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "LILLIANIS",
        "middle_name": "JALIERIS",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-17",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH14082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016903800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.