PATRICA SHACKLEFORD (NPI# 1316361801) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1316361801 |
Entity Type | Individual |
Full Name | PATRICA SHACKLEFORD |
Credential | PH.D. |
Practice Address |
2380 Se County Road 21b Melrose FL 32666-5113 |
Practice Telephone | 3524753311 |
Practice Fax Number | 8668112779 |
Mailing Telephone | 3524753311 |
Mailing Fax Number | 8668112779 |
Enumeration Date | 2014-02-05 |
Last Update Date | 2014-02-05 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101YM0800X |
Counselor Specialization: Mental Health |
MH5805 | FL | Behavioral Health & Social Service Providers |
N | 103TS0200X |
Psychologist Specialization: School |
SS 475 | FL | Behavioral Health & Social Service Providers |
Street Address |
2380 SE COUNTY ROAD 21B |
City | MELROSE |
State | FL |
Zip Code | 32666-5113 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487166021 | Sandra June Northway | Nurse Practitioner | 1326 Fl-100 Melrose, Fl 32666, Melrose, FL 32666 | 2017-11-03 |
1477932408 | Eswt Inc | Specialist | 671 Se 5th Avenue, Box 91, Melrose, FL 32666 | 2015-05-22 |
1770722936 | Medical and Wellness Center of Melrose Corporation | Clinic/Center | 1745 Sr 100, Melrose, FL 32666 | 2009-02-11 |
1598987786 | Jeffrey C Smith | Dentist | 100 S R 26, Melrose, FL 32666 | 2007-05-03 |
1558491555 | Elisa Neale-tobener | Speech-Language Pathologist | 861 Hwy 21, Melrose, FL 32666 | 2007-03-07 |
1649280785 | Laura S Hodges | Physical Therapist | 25727 Ne Sr 26, Melrose, FL 32666 | 2006-08-09 |
1376682518 | Lake Area Physical Therapy Inc | Occupational Therapist | 25727 Ne State Rd 26, Melrose, FL 32666-1099 | 2007-02-05 |
1417150905 | Richard C Sturdivant | Specialist | 123 1st St, Melrose, FL 32666-3030 | 2007-06-11 |
1194104414 | Anne Wister | Specialist | 102 Serenity Dr, Melrose, FL 32666-3032 | 2015-05-19 |
1609033646 | Canaide Inc | Supports Brokerage | 723 State Road 26, Melrose, FL 32666-3139 | 2008-05-19 |
Find all providers in zip 32666 |
Taxonomy Code | 101YM0800X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Mental Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235736489 | Jillian M Boyle | Counselor | 500 Main St Apt 5, Melrose, MA 02176-3828 | 2020-10-01 |
1760977003 | Patricia Ruth Lytwyn | Counselor | 243 Beech Ave, Melrose, MA 02176-5003 | 2018-06-28 |
1588067953 | Gabrielle Wolfe | Counselor | 119 W Wyoming Ave Apt C, Melrose, MA 02176-3751 | 2014-09-30 |
1689073488 | Michelle Shafer | Counselor | 117 Upham St, Melrose, MA 02176-3529 | 2014-08-18 |
1083049712 | Randi A Brown | Counselor | 610 A Main Street, Melrose, MA 02176 | 2013-09-12 |
1558678128 | Lisa Silveria | Counselor | 31 Fairmount St, Melrose, MA 02176-4812 | 2010-09-02 |
1730317793 | Kimberly Bennett Barad | Counselor | 12 Wildwood Rd, Melrose, MA 02176-3412 | 2009-06-29 |
1851585558 | Debra A Broadley | Counselor | 35 Laurel St, Melrose, MA 02176-4023 | 2007-09-05 |
1073724233 | Lisa Marie Blaken-miller | Counselor | N9710 State Hwy 108, Melrose, WI 54642-8258 | 2007-05-26 |
1326058140 | Marcia M. Binder | Counselor | 91 East St, Melrose, MA 02176-3301 | 2006-08-08 |
Find all providers in MELROSE |
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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.