Integrated Life Counseling and Behavior Services

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

INTEGRATED LIFE COUNSELING AND BEHAVIOR SERVICES

Practice address

200 Waymont CT Ste 126-10
Lake Mary, FL 32746-3413

Phone

(407) 488-7927

Fax

(407) 603-0414

NPI assigned

Feb 22, 2019

Last updated

Oct 20, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Anacarolina Vaughn, LMHCNPI 1366972226

Title

Owner

Phone

(321) 848-1916

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anacarolina Vaughn, MS, MED, LMHC

  • Professional Counselor
  • Lake Mary, FL
  • NPI 1366972226

  Mental Health

  NPD Authorized official

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

{
    "created_epoch": "1550793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634688000000",
    "number": "1679030084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 2ND PL",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327503029",
            "telephone_number": "321-848-1916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 WAYMONT CT STE 126-10",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327463413",
            "telephone_number": "407-488-7927",
            "fax_number": "407-603-0414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED LIFE COUNSELING AND BEHAVIOR SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-22",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A",
        "authorized_official_last_name": "VAUGHN",
        "authorized_official_first_name": "ANACAROLINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-848-1916",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "39- MEDICAID",
            "identifier": "021251000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Lake Mary, FL
• Providers in Lake Mary, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2021; 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.