Individual provider Active NPI

Damarys J Gilligan, EDD, LMHC, NCC

  • Mental Health Counselor
  • Pembroke Pines, FL
National Provider Identifier
1700412657
Registry record updated Jan 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH16102 Issued in FL
Practice address
285 NW 164TH Ave
Pembroke Pines, FL 33028-1131
Phone
(954) 372-8007
NPI assigned
Mar 22, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2024

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 MH16102 FL Primary

Addresses

Primary practice location

285 NW 164TH Ave
Pembroke Pines, FL 33028-1131

Mailing address

16000 Pines Blvd # 2042
Pembroke Pines, FL 33082-9200
Phone (954) 372-8007

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
I20250509001558 FL Practitioner - Mental Health Counselor 7416474713 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH16102FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Mental Health CurrentSince May 9, 2025 Accepting new patients
Teladoc Health Medical Group, P.a. Mental Health Current Accepting new patients

Locations

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

Interoperability endpoints

  • Direct secure messaging: damarysgilligan@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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1584835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1700412657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16000 PINES BLVD # 2042",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330829200",
            "telephone_number": "954-372-8007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 NW 164TH AVE",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330281131",
            "telephone_number": "954-372-8007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIGAN",
        "first_name": "DAMARYS",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "EDD, LMHC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-22",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH16102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.