Individual provider Active NPI

Greta Wendorf, LMHC

  • Mental Health Counselor
  • Lauderdale Lakes, FL
National Provider Identifier
1932815396
Registry record updated Jan 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH21488 Issued in FL
Practice address
4900 W Oakland Park Blvd Ste 101
Lauderdale Lakes, FL 33313-1555
Phone
(305) 398-6100
Fax
(305) 774-3355
NPI assigned
Jan 27, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2023

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 MH21488 FL Primary

Addresses

Primary practice location

4900 W Oakland Park Blvd Ste 101
Lauderdale Lakes, FL 33313-1555

Mailing address

6100 Blue Lagoon Dr Ste 400
Miami, FL 33126-2080
Phone (305) 398-6186

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
I20231129001806 FL Practitioner - Mental Health Counselor 9133577364 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thriveworks Clinical - Florida IncGroup PAC ID 5496173577, 85 clinicians

Practice addresses (Care Compare)

10100 W Sample Rd
Suite 205
Coral Springs, FL 33065-3975
Phone (855) 284-7483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH21488FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Thriveworks Clinical - Florida Inc Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

10100 W Sample Rd
Ste 205
Coral Springs, FL 33065
Phone (561) 771-5838

2425 E Commercial Blvd
Ste 405
Fort Lauderdale, FL 33308
Phone (754) 400-5514

4115 W Spruce St
Ste 205
Tampa, FL 33607
Phone (813) 413-4663

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

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": "1674777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674777600000",
    "number": "1932815396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 BLUE LAGOON DR STE 400",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331262080",
            "telephone_number": "305-398-6186",
            "fax_number": "305-774-3355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 W OAKLAND PARK BLVD STE 101",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333131555",
            "telephone_number": "305-398-6100",
            "fax_number": "305-774-3355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENDORF",
        "first_name": "GRETA",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-27",
        "last_updated": "2023-01-27",
        "certification_date": "2023-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH21488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lauderdale Lakes, FL

Sources for this page

Verify at the official NPI Registry.