LVH FL Telehealth PLLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

LVH FL TELEHEALTH PLLC

Practice address

1900 Corporate Square Blvd
Jacksonville, FL 32216-1941

Phone

(904) 515-5086

Fax

(866) 541-5354

NPI assigned

Feb 23, 2021

Organization subpart

No

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

Authorized official

Name

Lisa Lynne Lasick

Title

Director of RCM

Phone

(954) 559-1378

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1614038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623024000000",
    "number": "1962096743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4458",
            "address_2": "DEPT 841",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772104458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 CORPORATE SQUARE BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322161941",
            "telephone_number": "904-515-5086",
            "fax_number": "866-541-5354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LVH FL TELEHEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-23",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A",
        "authorized_official_last_name": "LASICK",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "DIRECTOR OF RCM",
        "authorized_official_telephone_number": "954-559-1378"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Mental Health Clinic/Center in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Adult Mental Health Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; 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.