Individual provider Active NPI

Odalys J. Waugh, LMHC

  • Mental Health Counselor
  • Miami, FL
National Provider Identifier
1790715514
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH8795 Issued in FL
Practice address
9000 SW 137TH Ave Ste 103
Miami, FL 33186-1435
Phone
(305) 671-3503
Fax
(305) 671-3505
NPI assigned
Jul 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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 MH8795 FL Primary

Addresses

Primary practice location

9000 SW 137TH Ave Ste 103
Miami, FL 33186-1435

Mailing address

9000 SW 137TH Ave Ste 103
Miami, FL 33186-1435
Phone (305) 671-3503

Other practice location 1

6800 N Dale Malbry Hwy
Suite 150
Tampa, FL 33614-3997
Phone (305) 671-3503

Other identifiers 1

IdentifierTypeStateIssuer
MH8795OtherFLLIC MENTAL HEALTH COUNS

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
I20240221000032 FL Practitioner - Mental Health Counselor 7012341340 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Collaborative Care Solutions, LLC Mental Health CurrentSince Jan 11, 2024 Accepting new patients

Locations

9000 SW 137th Ave
Ste 103
Miami, FL 33186
Phone (305) 671-3503

Interoperability endpoints

  • Direct secure messaging: fbh.odalyswaugh@141363.advancedmd-direct.com

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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1790715514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 SW 137TH AVE STE 103",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331861435",
            "telephone_number": "305-671-3503",
            "fax_number": "305-671-3505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 SW 137TH AVE STE 103",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331861435",
            "telephone_number": "305-671-3503",
            "fax_number": "305-671-3505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6800 N Dale Malbry Hwy",
            "address_2": "Suite 150",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336143997",
            "country_code": "US",
            "telephone_number": "305-671-3503",
            "fax_number": "305-671-3505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAUGH",
        "first_name": "ODALYS",
        "middle_name": "J.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH8795",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC MENTAL HEALTH COUNS",
            "identifier": "MH8795",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.