Active NPI
Brianna Desouza
- Mental Health Counselor
- Eustis, FL
National Provider Identifier
1861844284
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MH16967
- Practice address
- 1217 Huffstetler Dr
Eustis, FL 32726-8225 - Phone
- (352) 483-1652
- NPI assigned
- Jul 9, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MH16967 | FL | Primary |
Addresses
Primary practice location
1217 Huffstetler Dr
Eustis, FL 32726-8225
Mailing address
PO Box 491000
Leesburg, FL 34749-1000
Phone (352) 315-7500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 102544400 | Medicaid | FL |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MH16967 | FL | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifestream Behavioral Center Inc | Past | Accepting new patients | |
| Lifestream Behavioral Center Inc | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Primary Care Clinic/Center
- Leesburg, FL
- NPI 1659613776
-
- Psychiatric Hospital
- Leesburg, FL
- NPI 1902802002
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558483200000",
"number": "1861844284",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 491000",
"city": "LEESBURG",
"state": "FL",
"postal_code": "347491000",
"telephone_number": "352-315-7500",
"fax_number": "352-315-7587"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1217 HUFFSTETLER DR",
"city": "EUSTIS",
"state": "FL",
"postal_code": "327268225",
"telephone_number": "352-483-1652"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESOUZA",
"first_name": "BRIANNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-09",
"last_updated": "2019-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH16967",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "102544400",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eustis, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.