Individual provider Active NPI

Lakisha Foxworth

  • Marriage & Family Therapist
  • West Palm BCH, FL
National Provider Identifier
1790447324
Registry record updated Nov 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MT4139 Issued in FL
Practice address
611 6TH Way
West Palm BCH, FL 33407-6672
Phone
(561) 316-7591
NPI assigned
Oct 11, 2021
Last updated
Nov 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MT4139 FL Primary

Addresses

Primary practice location

611 6TH Way
West Palm BCH, FL 33407-6672

Mailing address

611 6TH Way
West Palm BCH, FL 33407-6672
Phone (561) 316-7591

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240101000174 FL Practitioner - Marriage and Family Therapist 2961852165 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MT4139FLMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wellqor Psychological Services, PC CurrentSince Jan 14, 2025 Accepting new patients
Marriage & Family Services, Inc. CurrentSince Dec 21, 2023 Accepting new patients

Locations

433 Plaza Real
Ste 275
Boca Raton, FL 33432
Phone (561) 262-0084

15204 S Jog Rd
Ste 303
Delray Beach, FL 33446
Phone (561) 503-3059

4455 Merrimac Ave
Jacksonville, FL 32210
Phone (904) 389-5959

4870 Belfort Rd
Jacksonville, FL 32256
Phone (904) 332-0774

4250 Lakeland Highlands Rd
Lakeland, FL 33813
Phone (863) 224-3553

5501 E Michigan St
Orlando, FL 32822
Phone (407) 277-7225

5433 W State Road 46
Sanford, FL 32771
Phone (407) 322-2207

4902 Bayshore Blvd
Tampa, FL 33611
Phone (813) 416-9814

135 Pinelawn Rd
Ste 204N
Melville, NY 11747
Phone (631) 328-2440

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1633910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669593600000",
    "number": "1790447324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 6TH WAY",
            "city": "WEST PALM BCH",
            "state": "FL",
            "postal_code": "334076672",
            "telephone_number": "561-316-7591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 6TH WAY",
            "city": "WEST PALM BCH",
            "state": "FL",
            "postal_code": "334076672",
            "telephone_number": "561-316-7591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOXWORTH",
        "first_name": "LAKISHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-11",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT4139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm BCH, FL

Sources for this page

Verify at the official NPI Registry.