Lakeside Behavioral Healthcare, Inc. – Mental Health Clinic/Center (Including Community Mental Health Center), NPI 1821033903
Mental Health Clinic/Center (Including Community Mental Health Center)
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Lakeside Behavioral Healthcare, Inc.
100 Columbia St
Orlando, FL 328061006
Phone: (407) 875-3700
Type: Location
4670 Lipscomb St NE
Palm Bay, FL 329052927
Phone: (407) 875-3700
Type: Location
3905 Grissom Pkwy
Cocoa, FL 329263669
Phone: (407) 875-3700
Type: Location
237 Fernwood Blvd
Fern Park, FL 327302116
Phone: (407) 875-3700
Type: Location
96 Plumosa Ave
Casselberry, FL 327072937
Phone: (407) 875-3700
Type: Location
5029 North Ln
Orlando, FL 328082088
Phone: (407) 875-3700
Type: Location
4508 Thistledown Dr
Orlando, FL 328041244
Phone: (407) 875-3700
Type: Location
351 S Bay Ave
Sanford, FL 327712140
Phone: (407) 875-3700
Type: Location
919 E 2nd St
Sanford, FL 327712101
Phone: (407) 875-3700
Type: Location
434 W Kennedy Blvd
Orlando, FL 328106237
Phone: (407) 875-3700
Type: Location
1975 S John Young Pkwy
Kissimmee, FL 347410603
Phone: (407) 875-3700
Type: Location
1405 W Michigan St
Orlando, FL 328056123
Phone: (407) 875-3700
Type: Location
8301 E Colonial Dr
Orlando, FL 328173909
Phone: (407) 875-3700
Type: Location
300 S Bay Ave
Sanford, FL 327712141
Phone: (407) 875-3700
Type: Location
5970 S. Orange Blossom Trail
Intercession City, FL 33848
Phone: (407) 875-3700
Type: Location
924 Determination Way
Kissimmee, FL 347416017
Phone: (407) 875-3700
Type: Location
5600 Clarcona Ocoee Rd
Orlando, FL 328103213
Phone: (407) 875-3700
Type: Location
5151 ADANSON ST STE 201
ORLANDO, FL 328041330
Phone: (407) 875-3700
Fax: (407) 623-1037
Type: Mailing
1800, Mercy Drive, Orlando, Orange County, Florida, 32808, United States
ORLANDO, FL 328085646
Phone: (407) 875-3700
Fax: (407) 522-4671
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-12-16
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2026-03-31 (69 days ago).
Enrollment records
3
Earliest due date
2026-03-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20040309000953 | O | Clinic/Group Practice | FL | TBD |
| O20101130001396 | O | Hospital | FL | TBD |
| O20191216000524 | O | Opioid Treatment Program (Otp) | FL | 2026-03-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32806)
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