Alicia L Heningburg, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

721 Oak Commons Blvd Ste a
Kissimmee, FL 34741-4186

Phone

(407) 518-9505

Fax

(407) 518-9507

NPI assigned

Aug 28, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Alicia Lasalle Heningburg Professional name

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

Specialty

Mental Health Counselor

Education

Other, 2011

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Family Life Services Ministries & Counseling, Inc

  • Community/Behavioral Health Agency
  • Kissimmee, FL
  • NPI 1093148306
  Medicare reassignment Authorized official
• Family Life Services Ministries & TCM, Inc.

  • Community/Behavioral Health Agency
  • Kissimmee, FL
  • NPI 1760830640
  NPD Authorized official
• Shekinah Family Counseling Services, LLC

  • Mental Health Counselor
  • Kissimmee, FL
  • NPI 1124945779
  NPD (past) Authorized official

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

{
    "created_epoch": "1346112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1972851657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 OAK COMMONS BLVD STE A",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414186",
            "telephone_number": "407-518-9505",
            "fax_number": "407-518-9507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 OAK COMMONS BLVD STE A",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414186",
            "telephone_number": "407-518-9505",
            "fax_number": "407-518-9507"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 N Central Ave",
            "address_2": "Suite 212",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "347414450",
            "country_code": "US",
            "telephone_number": "407-518-9505",
            "fax_number": "407-518-9507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENINGBURG",
        "first_name": "ALICIA",
        "middle_name": "L",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-28",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH11963",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALICIA",
            "last_name": "LASALLE HENINGBURG",
            "credential": "LMHC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Carla Henriquez Marques, RBT
• Jessica Klein Henriquez
• Richard Henriquez
• Marcia M Henry, LPN

• Mental Health Counselor in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.