MRS. LAURA ANN STAFFORD (NPI# 1104050178) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104050178 |
| Entity Type | Individual |
| Full Name | MRS. LAURA ANN STAFFORD |
| Credential | LICSW |
| Practice Address |
12550 New Brittany Blvd Suite 201 Fort Myers FL 33907-3655 |
| Practice Telephone | 2393439190 |
| Mailing Telephone | 2393439190 |
| Enumeration Date | 2009-05-06 |
| Last Update Date | 2015-04-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 111844 | MA | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245848423 | Laura Stafford | Nurse Practitioner | 300 N Commercial St, Neenah, WI 54956-2619 | 2020-07-14 |
| 1447436779 | Laura M Stafford | Registered Nurse | 499 Humboldt St, Santa Rosa, CA 95404-4214 | 2008-01-16 |
| 1083741615 | Laura Stafford | Specialist/Technologist | 4403 Far Hills Ave, Kettering, OH 45429-2405 | 2007-02-28 |
| Street Address |
12550 NEW BRITTANY BLVD SUITE 201 |
| City | FORT MYERS |
| State | FL |
| Zip Code | 33907-3655 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477524650 | Melanie Silcox Aracri | Nutritionist | 12550 New Brittany Blvd, Suite 200, Fort Myers, FL 33907-3655 | 2006-01-27 |
| 1902379209 | Lee Memorial Health System | General Practice | 12550 New Brittany Blvd, Fort Myers, FL 33907-3655 | 2019-01-09 |
| 1346711462 | Lucille Ann Rosso | Registered Nurse | 12550 New Brittany Blvd, Fort Myers, FL 33907-3655 | 2018-12-16 |
| 1922595578 | Deborah Ann Whitehair | Social Worker | 12550 New Brittany Blvd, Fort Myers, FL 33907-3655 | 2018-04-19 |
| 1467949628 | Jonathan L Fucella | Social Worker | 12550 New Brittany Blvd, Fort Myers, FL 33907 | 2018-04-13 |
| 1669915757 | Jasminet Pathak | Social Worker | 12550 New Brittany Blvd, Fort Myers, FL 33907-3655 | 2016-11-22 |
| 1417405663 | Julie Catherine Hill | Dietitian, Registered | 12550 New Brittany Blvd, Suite 200, Fort Myers, FL 33907-3655 | 2016-09-16 |
| 1942657994 | David Contos | Social Worker | 12550 New Brittany Blvd, Fort Myers, FL 33907 | 2016-05-19 |
| 1174939144 | Jayme L Hodges | Social Worker | 12550 New Brittany Blvd, Fort Myers, FL 33907-3655 | 2014-07-10 |
| 1962826024 | Colleen Hosp | Registered Nurse | 12550 New Brittany Blvd, Fort Myers, FL 33907-3655 | 2014-02-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134739253 | Islande Dorcin | Social Worker | 13300 South Cleveland Ave Suite 56 # 822, Fort Myers, FL 33907 | 2020-08-04 |
| 1003462268 | Ronny Rodolfo Herrera | Behavior Technician | Beacon Executive Suites, 8359 Beacon Blvd, Suite#416, Homestead, FL 33907 | 2019-08-14 |
| 1528549094 | Deborah Senese Streater | Dentist | 12530 New Brittany Blvd., Fort Myers, FL 33907 | 2018-08-23 |
| 1437648391 | Rita Lusinete Rabitt | Registered Nurse | 14084 Clear Water Ln, Fort Myers, FL 33907 | 2018-05-07 |
| 1972092146 | Surgery Centre of Sw Florida LLC | Clinic/Center | 13051 University Dr Ste 102, Fort Myers, FL 33907 | 2018-05-03 |
| 1740787761 | Care Transport Inc | Non-emergency Medical Transport (VAN) | 7850 Reflection Cove Dr, Fort Myers, FL 33907 | 2018-04-06 |
| 1942730692 | Concierge Care of Fort Myers, LLC | In Home Supportive Care | 12253 New Brittany Boulevard, Suite 32, Fort Myers, FL 33907 | 2017-06-15 |
| 1710411467 | Johnnie Terrell | Social Worker | 43 Barkley Cir #102, Fort Myers, FL 33907 | 2017-04-19 |
| 1881041184 | Hchs Medical Center | Clinic/Center | 35 Barkley Circle, Unit 2, Fort Myers, FL 33907 | 2016-05-17 |
| 1043665227 | Tong Liu | Dentist | 8016 Summerlin Lakes Dr, Fort Myers, FL 33907 | 2016-04-26 |
| Find all providers in zip 33907 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831748706 | The National Center for Life and Liberty | Residential Treatment Facility, Emotionally Disturbed Children | 13702 Green Isle Ter, Clermont, FL 34711-8426 | 2019-09-04 |
| 1881177509 | Sailfuture | Residential Treatment Facility, Emotionally Disturbed Children | 2900 68th Ave S, St Petersburg, FL 33712-5525 | 2018-09-09 |
| 1760892111 | Loving Arms Outreach, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 608 Nw 15th Ave, Pompano Beach, FL 33069-2829 | 2014-05-06 |
| 1689016560 | Alternate Group Care, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 20250 Sw 50th Pl, Southwest Ranches, FL 33332-1021 | 2013-07-22 |
| 1528304714 | Linda Newsome | Residential Treatment Facility, Emotionally Disturbed Children | 1454 Bent Oaks Blvd, Deland, FL 32724-8062 | 2012-12-17 |
| 1528327335 | G4s Youth Services LLC | Residential Treatment Facility, Emotionally Disturbed Children | 6302 Benjamin Rd Ste 400, Tampa, FL 33634-5116 | 2012-05-14 |
| 1003172073 | Esther's Group Home Corp. | Residential Treatment Facility, Emotionally Disturbed Children | 20115 Highland Lakes Blvd, N Miami Beach, FL 33179-2813 | 2012-04-04 |
| 1841584265 | D & R Rahabilitation Service Corp | Residential Treatment Facility, Emotionally Disturbed Children | 8567 Coral Way # 156, Miami, FL 33155-2335 | 2011-06-02 |
| 1003146887 | Sequel Tsi of Florida, LLC Daytona Transitional | Residential Treatment Facility, Emotionally Disturbed Children | 1386 Indian Lake Rd, Daytona Beach, FL 32124-1001 | 2009-12-30 |
| 1568795615 | Elite Behavioral Health Center | Residential Treatment Facility, Emotionally Disturbed Children | 611 Ne 13th St, Ft Lauderdale, FL 33304-1109 | 2009-09-08 |
| Find all providers with the same taxonomy | ||||
| City | FORT MYERS |
| Zip Code | 33907 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.