Individual provider Active NPI

Laura Mantelll, LMFT

  • Marriage & Family Therapist
  • Davie, FL
National Provider Identifier
1659637510
Registry record updated Apr 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MT2592 Issued in FL
Practice address
7450 Griffin Rd Ste 250
Davie, FL 33314-4104
Phone
(954) 800-0279
NPI assigned
Apr 5, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MT2592 FL Primary

Addresses

Primary practice location

7450 Griffin Rd Ste 250
Davie, FL 33314-4104

Mailing address

10275 Collins Ave Apt 815
Bal Harbour, FL 33154-1422
Phone (954) 800-0279

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
MT2592FLMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1333584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333584000000",
    "number": "1659637510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10275 COLLINS AVE APT 815",
            "city": "BAL HARBOUR",
            "state": "FL",
            "postal_code": "331541422",
            "telephone_number": "954-800-0279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7450 GRIFFIN RD STE 250",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333144104",
            "telephone_number": "954-800-0279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTELLL",
        "first_name": "LAURA",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-05",
        "last_updated": "2012-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT2592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2012; 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.