Active NPI
Lourdes Hernandez, PSY.D
- Psychologist
- Virginia Gardens, FL
National Provider Identifier
1972937324
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PY8826
- Practice address
- 6555 NW 36TH St
Ste 209
Virginia Gardens, FL 33166-6978 - Phone
- (305) 775-0916
- Fax
- (305) 602-9834
- NPI assigned
- Aug 21, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 10
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | |||
| Psychologist | 103T00000X | PY8826 | FL | Primary |
| Adult Development & Aging Psychologist | 103TA0700X | |||
| Cognitive & Behavioral Psychologist | 103TB0200X | |||
| Counseling Psychologist | 103TC1900X | |||
| Clinical Child & Adolescent Psychologist | 103TC2200X | |||
| Family Psychologist | 103TF0000X | |||
| Health Service Psychologist | 103TH0100X | |||
| Group Psychotherapy Psychologist | 103TP2701X | |||
| Rehabilitation Psychologist | 103TR0400X |
Addresses
Primary practice location
6555 NW 36TH St
Ste 209
Virginia Gardens, FL 33166-6978
Mailing address
6555 NW 36TH St
Ste 209
Virginia Gardens, FL 33166-6978
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140102001622 | FL | Practitioner - Clinical Psychologist | 7012145782 | Practice locations: Miami, FL |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY8826 | FL | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1377043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472774400000",
"number": "1972937324",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6555 NW 36TH ST",
"address_2": "STE 209",
"city": "VIRGINIA GARDENS",
"state": "FL",
"postal_code": "331666978",
"fax_number": "305-602-9834"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6555 NW 36TH ST",
"address_2": "STE 209",
"city": "VIRGINIA GARDENS",
"state": "FL",
"postal_code": "331666978",
"telephone_number": "305-775-0916",
"fax_number": "305-602-9834"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERNANDEZ",
"first_name": "LOURDES",
"credential": "PSY.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-08-21",
"last_updated": "2016-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "FL",
"license": "PY8826",
"primary": true
},
{
"code": "103TA0700X",
"taxonomy_group": "",
"desc": "Psychologist, Adult Development & Aging",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TF0000X",
"taxonomy_group": "",
"desc": "Psychologist, Family",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TH0100X",
"taxonomy_group": "",
"desc": "Psychologist, Health Service",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TP2701X",
"taxonomy_group": "",
"desc": "Psychologist, Group Psychotherapy",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TR0400X",
"taxonomy_group": "",
"desc": "Psychologist, Rehabilitation",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Virginia Gardens, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2016; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.