Individual provider Active NPI

Lourdes Berlanga, LMFT

  • Marriage & Family Therapist
  • McAlpin, FL
National Provider Identifier
1922644079
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MT4299 Issued in FL
Practice address
11985 County Road 252
MC Alpin, FL 32062-3206
Phone
(786) 398-2112
NPI assigned
Nov 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X MT4299 FL
Case Manager/Care Coordinator 171M00000X CBHCM101389 FL
Marriage & Family Therapist 106H00000X MT4299 FL Primary

Addresses

Primary practice location

11985 County Road 252
MC Alpin, FL 32062-3206

Mailing address

100 Court St SE Ste 105
Live Oak, FL 32064-3203
Phone (386) 209-8734

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
I20240507000309 FL Practitioner - Marriage and Family Therapist 1951741024 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MT4299FLMDProfessional Counselor
CBHCM101389FLMDCase Manager/Care Coordinator

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Mental Health CurrentSince Apr 8, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

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": "1574640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1922644079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 COURT ST SE STE 105",
            "city": "LIVE OAK",
            "state": "FL",
            "postal_code": "320643203",
            "telephone_number": "386-209-8734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11985 COUNTY ROAD 252",
            "city": "MC ALPIN",
            "state": "FL",
            "postal_code": "320623206",
            "telephone_number": "786-398-2112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERLANGA",
        "first_name": "LOURDES",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-25",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "FL",
            "license": "MT4299",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "FL",
            "license": "CBHCM101389",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT4299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McAlpin, FL

Sources for this page

Verify at the official NPI Registry.