Individual provider Active NPI

Lissette Gomez, L.M.F.T.

  • Marriage & Family Therapist
  • Miami, FL
National Provider Identifier
1740511492
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT 78326 Issued in CA
Practice address
2500 SW 107TH Ave Ste 42
Miami, FL 33165-2492
Phone
(786) 615-3334
NPI assigned
Jan 20, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MT3351 FL
Marriage & Family Therapist 106H00000X LMFT 78326 CA Primary

Addresses

Primary practice location

2500 SW 107TH Ave Ste 42
Miami, FL 33165-2492

Mailing address

2500 SW 107TH Ave Ste 42
Miami, FL 33165-2492
Phone (786) 615-3334

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
LMFT 78326CAMDMarriage & Family Therapist
MT3351FLMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Behavioral & Counseling Services, LLC Current Accepting new patients
Advanced Behavioral & Counseling Services Current Accepting new patients

Locations

2500 SW 107th Ave
Ste 41
Miami, FL 33165
Phone (305) 485-1532

2500 SW 107th Ave
Ste 42
Miami, FL 33165
Phone (305) 554-4333

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": "1263945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1740511492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 SW 107TH AVE STE 42",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331652492",
            "telephone_number": "786-615-3334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 SW 107TH AVE STE 42",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331652492",
            "telephone_number": "786-615-3334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "LISSETTE",
        "credential": "L.M.F.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-20",
        "last_updated": "2023-06-13",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT3351",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT 78326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2023; 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.