Individual provider Active NPI

Libertad Fantauzzi

  • Mental Health Counselor
  • Orlando, FL
National Provider Identifier
1831548056
Registry record updated Jun 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
5747 Crowntree LN Apt 8-302
Orlando, FL 32829-8050
Phone
(757) 354-4107
NPI assigned
Jun 8, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2016

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 Primary

Addresses

Primary practice location

5747 Crowntree LN Apt 8-302
Orlando, FL 32829-8050

Mailing address

5747 Crowntree LN 302 Apt 8-302
Orlando, FL 32829
Phone (757) 354-4107

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1465344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465344000000",
    "number": "1831548056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5747 CROWNTREE LN 302 APT 8-302",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32829",
            "telephone_number": "757-354-4107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5747 CROWNTREE LN APT 8-302",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328298050",
            "telephone_number": "757-354-4107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANTAUZZI",
        "first_name": "LIBERTAD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-08",
        "last_updated": "2016-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.