IVANNA REBECCA PENGELLEY (NPI# 1275185993) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275185993 |
| Entity Type | Individual |
| Full Name | IVANNA REBECCA PENGELLEY |
| Practice Address |
2110 S Gadsden St Tallahassee FL 32301-5513 |
| Practice Telephone | 5613099746 |
| Mailing Telephone | 5613099746 |
| Enumeration Date | 2019-07-12 |
| Last Update Date | 2019-07-12 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Street Address |
2110 S GADSDEN ST |
| City | TALLAHASSEE |
| State | FL |
| Zip Code | 32301-5513 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790386092 | Rebecca Klein | Behavior Technician | 2331 Hansen Court Tallahassee, Fl 32301, Tallahassee, FL 32301 | 2020-11-03 |
| 1093314692 | Rothschild Counseling and Consulting, LLC | Marriage & Family Therapist | 820 E. Park Ave, Suite F 100, Tallahassee, FL 32301 | 2020-10-23 |
| 1871192070 | Layata Shaundria Twitty-kiser | Licensed Practical Nurse | 2521 Spring Forest Road, Tallahassee, FL 32301 | 2020-10-20 |
| 1457967093 | Tahlah Austin | Behavior Technician | 113 South Monroe Street 1st Floor, Tallahassee, FL 32301 | 2020-09-18 |
| 1972133288 | Mary Lyn Norman | Marriage & Family Therapist | 119 Cadiz Street, #107, Tallahassee, FL 32301 | 2020-01-26 |
| 1285270520 | Norine Cardea | Counselor | The Healing Center, 847 East Park Avenue, Tallahassee, FL 32301 | 2019-11-21 |
| 1629635560 | Lily Ramey | Behavior Technician | 3010 Highland Oaks Ter, Tallahassee, FL 32301 | 2019-05-27 |
| 1861981052 | Mission of Hope of Tall Inc | Nurse's Aide | 1541 Glenway Dr, Tallahassee, FL 32301 | 2018-05-03 |
| 1770084824 | Bond Community Health Center, Inc. | Family Medicine | 2200 South Monroe, Tallahassee, FL 32301 | 2018-02-23 |
| 1356849236 | Amanda Mcglone | Developmental Therapist | 3010 Highland Oaks Terr, Tallahassee, FL 32301 | 2018-01-25 |
| Find all providers in zip 32301 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164053302 | Shango Husani | Peer Specialist | 2719 Hollywood Blvd Ste B208, Hollywood, FL 33020-4821 | 2020-01-27 |
| 1427698638 | Fire Forged Recovery, Inc | Peer Specialist | 2428 Nw 56th Ave, Lauderhill, FL 33313-3012 | 2020-01-15 |
| 1316584675 | Gainesville Peer Respite, Inc. | Peer Specialist | 728 E. University Avenue, Gainesville, FL 32601 | 2019-12-05 |
| 1639712078 | Josly Quintero | Peer Specialist | 99198 Overseas Hwy Ste 34&5, Key Largo, FL 33037-2437 | 2019-10-17 |
| 1386128205 | Theresa E Henderson | Peer Specialist | 2257 Sandy Ct, Orange Park, FL 32073-5235 | 2018-09-17 |
| 1134605330 | Cruz Ines Diaz | Peer Specialist | 3400 N- 29th Avenue, Hollywood, FL 33020 | 2018-07-11 |
| 1861900763 | Billing Tech Solutions Corp | Peer Specialist | 10201 Falcon Pine Blvd Apt 208, Orlando, FL 32829-7368 | 2018-01-14 |
| 1184133407 | Cindy Witt | Peer Specialist | 804 3rd St Ste Ab, Neptune Beach, FL 32266-5040 | 2017-09-29 |
| 1649796574 | Robbie Nelson | Peer Specialist | 1817 Se 13th Pl, Gainesville, FL 32641-8395 | 2017-08-22 |
| 1629468376 | Mental Health America of Northeast Florida, Inc. | Peer Specialist | 4615 Philips Hwy Ste 300, Jacksonville, FL 32207-9506 | 2015-02-03 |
| Find all providers with the same taxonomy | ||||
| City | TALLAHASSEE |
| Zip Code | 32301 |
Please comment or provide details below to improve the information on IVANNA REBECCA PENGELLEY.
| 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.