Individual provider Active NPI

Alessana Bryczkowski-Fordin, LMHC

  • Mental Health Counselor
  • Miami, FL
National Provider Identifier
1992960041
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH9137 Issued in FL
Practice address
2121 SW 3Rd Ave Ste 101
Miami, FL 33129-3000
Phone
(305) 915-5748
NPI assigned
Jul 28, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2024

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 MH9137 FL Primary

Addresses

Primary practice location

2121 SW 3Rd Ave Ste 101
Miami, FL 33129-3000

Mailing address

2121 SW 3Rd Ave Ste 101
Miami, FL 33129-3000
Phone (305) 915-5748

Other practice location 1

2999 NE 191st St Ste 709F
Aventura, FL 33180-3123
Phone (305) 915-5748

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MH9137FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lotus Management Consulting, Inc. Mental Health CurrentSince Apr 28, 2024 Accepting new patients

Locations

2121 SW 3rd Ave
Ste 101
Miami, FL 33129
Phone (305) 204-5364

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": "1217203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1992960041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 SW 3RD AVE STE 101",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331293000",
            "telephone_number": "305-915-5748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 SW 3RD AVE STE 101",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331293000",
            "telephone_number": "305-915-5748"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2999 NE 191st St Ste 709F",
            "address_purpose": "LOCATION",
            "city": "Aventura",
            "state": "FL",
            "postal_code": "331803123",
            "country_code": "US",
            "telephone_number": "305-915-5748",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRYCZKOWSKI-FORDIN",
        "first_name": "ALESSANA",
        "name_prefix": "Ms.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-28",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH9137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; 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.