Lydia Angelica Antonatos, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

17334 Issued in FL

Practice address

3732 Coachman LN SE
Palm Bay, FL 32909-1335

Phone

(954) 260-3979

NPI assigned

Oct 17, 2019

Last updated

Oct 11, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Foundations Counseling LLCGroup PAC ID 6305230137, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lydiaantonatos@tdh.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Foundations Counseling, LLC.

  • Community/Behavioral Health Agency
  • Melbourne, FL
  • NPI 1366090730
  Medicare reassignment Care Compare group NPD
• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Mental Health

  NPD

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

{
    "created_epoch": "1571270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1790328144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3732 COACHMAN LN SE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329091335",
            "telephone_number": "954-260-3979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3732 COACHMAN LN SE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329091335",
            "telephone_number": "954-260-3979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONATOS",
        "first_name": "LYDIA",
        "middle_name": "ANGELICA",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-17",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "17334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Palm Bay, FL
• Providers in Palm Bay, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.