Individual provider Active NPI

Madison Carbajales

  • Mental Health Counselor
  • Lake Worth, FL
National Provider Identifier
1639066087
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH25620 Issued in FL
Practice address
8461 Lake Worth Rd Ste 250
Lake Worth, FL 33467-2474
Phone
(561) 790-1191
NPI assigned
Jun 19, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

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 MH25620 FL Primary

Addresses

Primary practice location

8461 Lake Worth Rd Ste 250
Lake Worth, FL 33467-2474

Mailing address

855 SE Celtic Ave
Port Saint Lucie, FL 34983-2762

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
I20250708003568 FL Practitioner - Mental Health Counselor 2264946664 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cotler Healthcare & Development Inc. CurrentSince May 25, 2025 Accepting new patients
Grow Healthcare Group PA Mental Health CurrentSince Nov 5, 2025 Accepting new patients
Cotler Children and Family Services, LLC PastSince Jun 23, 2025 Accepting new patients

Locations

901 S 62nd Ave
Hollywood, FL 33023
Phone (954) 893-0109

9835 Lake Worth Rd
Ste 16179
Lake Worth, FL 33467

8461 Lake Worth Rd
Ste 250
Lake Worth, FL 33467

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

Organizations & group practices 3

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": "1750291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1639066087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 SE CELTIC AVE",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349832762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8461 LAKE WORTH RD STE 250",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334672474",
            "telephone_number": "561-790-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARBAJALES",
        "first_name": "MADISON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-19",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH25620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

Verify at the official NPI Registry.