Individual provider Active NPI

Evodie Antoine-Predestin, LMHC

  • Mental Health Counselor
  • Sunrise, FL
National Provider Identifier
1790211621
Registry record updated May 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH6312 Issued in FL
Practice address
7800 W Oakland Park Blvd
Suite 107
Sunrise, FL 33351-6741
Phone
(754) 281-7097
NPI assigned
May 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2017

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 MH6312 FL Primary

Addresses

Primary practice location

7800 W Oakland Park Blvd
Suite 107
Sunrise, FL 33351-6741

Mailing address

1856 N Nob Hill Rd
Suite 237
Plantation, FL 33322-6548
Phone (754) 281-7097

Other names 1

  • Evodie Antoine Former name

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
MH6312FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494460800000",
    "number": "1790211621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1856 N NOB HILL RD",
            "address_2": "SUITE 237",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333226548",
            "telephone_number": "754-281-7097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7800 W OAKLAND PARK BLVD",
            "address_2": "SUITE 107",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333516741",
            "telephone_number": "754-281-7097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTOINE-PREDESTIN",
        "first_name": "EVODIE",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH6312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EVODIE",
            "last_name": "ANTOINE",
            "credential": "LMHC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sunrise, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; 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.