Individual provider Active NPI

Karmivis Santiago, LMHC

  • Mental Health Counselor
  • Clearwater, FL
National Provider Identifier
1760693964
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH7942 Issued in FL
Practice address
25400 US Highway 19 N Ste 156
Clearwater, FL 33763-2150
Phone
(727) 480-0107
Fax
(727) 499-7555
NPI assigned
May 28, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2023

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 MH7942 FL Primary

Addresses

Primary practice location

25400 US Highway 19 N Ste 156
Clearwater, FL 33763-2150

Mailing address

25400 US Highway 19 N Ste 156
Clearwater, FL 33763-2150
Phone (727) 480-0107

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
MH7942FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Authentic Living Center, LLC CurrentSince Jan 29, 2023 Accepting new patients

Locations

25400 US Highway 19 N
Ste 156
Clearwater, FL 33763
Phone (727) 265-1147

Organizations & group practices 1

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": "1180310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1760693964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25400 US HIGHWAY 19 N STE 156",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337632150",
            "telephone_number": "727-480-0107",
            "fax_number": "727-499-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25400 US HIGHWAY 19 N STE 156",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337632150",
            "telephone_number": "727-480-0107",
            "fax_number": "727-499-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "KARMIVIS",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-28",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH7942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.