Individual provider Active NPI

Patricia I Requena, LMHC

  • Mental Health Counselor
  • Clearwater, FL
National Provider Identifier
1821247255
Registry record updated May 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH 10574 Issued in FL
Practice address
1938 Soule Rd
Clearwater, FL 33759-1507
Phone
(727) 726-7442
Fax
(727) 288-1111
NPI assigned
Sep 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2020

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 MH 10574 FL Primary

Addresses

Primary practice location

1938 Soule Rd
Clearwater, FL 33759-1507

Mailing address

1938 Soule Rd
Clearwater, FL 33759-1507
Phone (727) 726-7442

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
I20240108004099 FL Practitioner - Mental Health Counselor 9032560685 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aandm Psychiatric Services PAGroup PAC ID 9436175403, 10 clinicians

Practice addresses (Care Compare)

1938 Soule Rd
Clearwater, FL 33759-1507
Phone (727) 726-7442

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH 10574FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
A&M Psychiatric Services PA CurrentSince Jan 1, 2024 Accepting new patients

Locations

1938 Soule Rd
Clearwater, FL 33759
Phone (727) 726-7442

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, 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": "1221004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588809600000",
    "number": "1821247255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1938 SOULE RD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337591507",
            "telephone_number": "727-726-7442",
            "fax_number": "727-288-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1938 SOULE RD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337591507",
            "telephone_number": "727-726-7442",
            "fax_number": "727-288-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REQUENA",
        "first_name": "PATRICIA",
        "middle_name": "I",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-10",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 10574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.