PATRICA SHACKLEFORD


Address: 2380 Se County Road 21b, Melrose, FL 32666-5113
Phone: 3524753311

PATRICA SHACKLEFORD (NPI# 1316361801) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

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

Taxonomy

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

Office Location

Street Address 2380 SE COUNTY ROAD 21B
City MELROSE
State FL
Zip Code 32666-5113

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Taxonomy Information

Taxonomy Code 101YM0800X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Mental Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

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
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Competitor

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City MELROSE
Zip Code 32666

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Dataset Information

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.

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