Individual provider Active NPI

Nylsa Garcia-Aquino, LMHC

  • Mental Health Counselor
  • Fort Myers, FL
National Provider Identifier
1902321532
Registry record updated May 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
20560 Issued in FL
Practice address
12811 Kenwood LN Ste 202
Fort Myers, FL 33907-5646
Phone
(305) 709-7619
NPI assigned
Aug 4, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X IMH17588 FL
Mental Health Counselor 101YM0800X 20560 FL Primary

Addresses

Primary practice location

12811 Kenwood LN Ste 202
Fort Myers, FL 33907-5646

Mailing address

2215 Lincoln Park Ave
Alva, FL 33920-1015
Phone (305) 709-7619

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://secure.simplepractice.com/users/sign_in Other

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

LicenseStateTypeSpecialty
20560FLMDMental Health Counselor
IMH17588FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Treatment Team LLC Mental Health Past Accepting new patients

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": "1501804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1902321532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 LINCOLN PARK AVE",
            "city": "ALVA",
            "state": "FL",
            "postal_code": "339201015",
            "telephone_number": "305-709-7619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12811 KENWOOD LN STE 202",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339075646",
            "telephone_number": "305-709-7619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA-AQUINO",
        "first_name": "NYLSA",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-04",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH17588",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "20560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://secure.simplepractice.com/users/sign_in",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Practice Management",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Healthcare",
            "address_1": "12811 Kenwood Ln Ste 202",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339075646",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2022; 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.