Actual Psych Group LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW14095 Issued in FL

Legal business name

ACTUAL PSYCH GROUP LLC

Practice address

33 W 26TH St
Hialeah, FL 33010-1707

Phone

(305) 887-4163

NPI assigned

Feb 12, 2017

Last updated

Feb 12, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Liset FialloNPI 1346789278

Title

President

Phone

(305) 283-5497

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Liset Fiallo, LCSW

  • Mental Health Counselor
  • Miami, FL
  • NPI 1346789278
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1486857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486857600000",
    "number": "1790224624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 SW 124TH CT",
            "address_2": "APT C",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331842605",
            "telephone_number": "305-283-5497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 W 26TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330101707",
            "telephone_number": "305-887-4163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTUAL PSYCH GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-12",
        "last_updated": "2017-02-12",
        "status": "A",
        "authorized_official_last_name": "FIALLO",
        "authorized_official_first_name": "LISET",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-283-5497"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW14095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Hialeah, FL
• Providers in Hialeah, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.