Individual provider Active NPI

Mary Elizabeth Ann Laburda, LMHC

  • Mental Health Counselor
  • Rockledge, FL
National Provider Identifier
1679034946
Registry record updated Mar 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH15760 Issued in FL
Practice address
1041 Seminole Dr
Rockledge, FL 32955-1985
Phone
(321) 637-4703
Fax
(321) 632-6090
NPI assigned
Mar 28, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2019

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 MH15760 FL Primary

Addresses

Primary practice location

1041 Seminole Dr
Rockledge, FL 32955-1985

Mailing address

169 Seawind Dr
Satellite Beach, FL 32937-3072

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
MH15760FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553731200000",
    "number": "1679034946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 SEAWIND DR",
            "city": "SATELLITE BEACH",
            "state": "FL",
            "postal_code": "329373072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 SEMINOLE DR",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329551985",
            "telephone_number": "321-637-4703",
            "fax_number": "321-632-6090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LABURDA",
        "first_name": "MARY ELIZABETH",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-28",
        "last_updated": "2019-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH15760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockledge, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2019; 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.