Individual provider Active NPI

Yaima M. Mena, LMHC

  • Mental Health Counselor
  • Davie, FL
National Provider Identifier
1710336227
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH17340 Issued in FL
Practice address
3440 S University Dr
Davie, FL 33328-2000
Phone
(954) 424-6911
NPI assigned
Jun 6, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X MH17340 FL
Behavior Technician 106S00000X FL
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X MH17340 FL Primary

Addresses

Primary practice location

3440 S University Dr
Davie, FL 33328-2000

Mailing address

7767 Shalimar St
Miramar, FL 33023-2425

Other practice location 1

101 SW 117th Ave Apt 102
Pembroke Pines, FL 33025
Phone (305) 510-8552

Other practice location 2

8900 SW 107th Ave Ste 303
Miami, FL 33176-1451
Phone (786) 701-3109

Other identifiers 1

IdentifierTypeStateIssuer
017801300MedicaidFL

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
I20240102004072 FL Practitioner - Mental Health Counselor 3476903477

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Face to Face Mental Health Services, LLC Mental Health CurrentSince Jan 1, 2024 Accepting new patients
Influx Therapy Mental Health Incorporated CurrentSince Oct 1, 2020 Accepting new patients
Light of Hope Behavior Therapy Inc Past Accepting new patients

Locations

15924 SW 92nd Ave
Palmetto Bay, FL 33157
Phone (305) 964-5824

15954 SW 92ND Ave
Palmetto Bay, FL 33157
Phone (305) 964-5824

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": "1465171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1710336227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7767 SHALIMAR ST",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330232425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 S UNIVERSITY DR",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333282000",
            "telephone_number": "954-424-6911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 SW 117th Ave Apt 102",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "33025",
            "country_code": "US",
            "telephone_number": "305-510-8552",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8900 SW 107th Ave Ste 303",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331761451",
            "country_code": "US",
            "telephone_number": "786-701-3109",
            "fax_number": "305-503-6723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENA",
        "first_name": "YAIMA",
        "middle_name": "M.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-06",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "MH17340",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH17340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017801300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

Verify at the official NPI Registry.