MR. M SHAWN KELLERMAN (NPI# 1568535235) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568535235 |
| Entity Type | Individual |
| Full Name | MR. M SHAWN KELLERMAN |
| Credential | LMHC SAP MAC CAP CCJ |
| Practice Address |
3110 1st Ave N 2nd Floor Suite 6w St Petersburg FL 33733-6524 |
| Mailing Address |
Po Box 16524 St Petersburg FL 33733-6524 |
| Practice Telephone | 7275809117 |
| Practice Fax Number | 8139619787 |
| Mailing Telephone | 7275809117 |
| Mailing Fax Number | 8139619787 |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
1533CAT1533 | FL | Behavioral Health & Social Service Providers |
| X | 101YM0800X |
Counselor Specialization: Mental Health |
MH3987 | FL | Behavioral Health & Social Service Providers |
| Street Address |
3110 1ST AVE N 2ND FLOOR SUITE 6W |
| City | ST PETERSBURG |
| State | FL |
| Zip Code | 33733-6524 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285836114 | Shankara B Mangipudy | Internal Medicine | 205 Martin Luther King Street North, Suite 420, Saint Petersburg, FL 33733 | 2007-06-04 |
| 1356358899 | Theophil Thomas Sutton | Preventive Medicine | 10000 Bay Pines Blvd, Bay Pines, FL 33733 | 2006-08-01 |
| 1639403173 | Ida Lou Mercer | Clinical Nurse Specialist | 4024 Central Ave., St. Petersburg, FL 33733-0970 | 2009-10-01 |
| 1881845543 | Geraldo A Ramos | Internal Medicine | 620 10th Street N., St. Petersburg, FL 33733-1407 | 2008-09-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770423 | Nickole Marguerite Wyse | Counselor | 7901 4th St N Ste 4000, St Petersburg, FL 33702-4305 | 2020-11-06 |
| 1073113510 | Got Smile, Inc | Durable Medical Equipment & Medical Supplies | 180 4th Ave Ne, St Petersburg, FL 33701-3445 | 2020-10-26 |
| 1598364747 | Sara Spiess | Counselor | 447 3rd Ave N Ste 204, St Petersburg, FL 33701-3245 | 2020-10-20 |
| 1558969378 | Odalys Caro | Physician Assistant | 6500 20th St N, St Petersburg, FL 33702-7112 | 2020-10-14 |
| 1053919951 | Rhc St Pete LLC | Family Medicine | 5999 Central Ave Ste 103, St Petersburg, FL 33710-8535 | 2020-10-13 |
| 1962000265 | Ebony Wright | Registered Nurse | 12000 4th St N Apt 24, St Petersburg, FL 33716-1709 | 2020-10-09 |
| 1477150134 | Traci Jones | Massage Therapist | 12000 4th St N Apt 44, St Petersburg, FL 33716-1710 | 2020-10-06 |
| 1699372490 | Westcare Gulfcoast Flroida Inc | Community/Behavioral Health | 1801 5th Ave N, St Petersburg, FL 33713-7109 | 2020-10-05 |
| 1912504747 | Option Care Enterprises, Inc. | Home Infusion | 2880 Scherer Dr N Ste 850, St Petersburg, FL 33716-1025 | 2020-10-05 |
| 1376150276 | Stephanie Gayle Barnes | Rehabilitation Practitioner | 610 47th Ave N, St Petersburg, FL 33703 | 2020-09-25 |
| Find all providers in ST PETERSBURG | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659983609 | Mindful Ways To Wellness | Counselor | 735 Arlington Ave N Ste 209, St Petersburg, FL 33701-3653 | 2020-08-20 |
| 1578031068 | The Well for Life, LLC | Counselor | 833 22nd St S Ste B, St Petersburg, FL 33712-2250 | 2018-11-02 |
| 1083073068 | Anthony Williams | Counselor | 2709 17th St S, St Petersburg, FL 33712-3603 | 2016-02-18 |
| 1194164939 | Robert Lynn Neri | Counselor | 5999 Central Ave Ste 401, St Petersburg, FL 33710 | 2013-06-14 |
| 1932419678 | Gerald Milton Syrkett | Counselor | 3730 42nd Way S, #l, St Petersburg, FL 33711-4077 | 2010-10-15 |
| 1508096694 | Hal Bishop, Lcsw, Pa | Counselor | 1905 Tyrone Blvd N, St Petersburg, FL 33710-4841 | 2009-07-22 |
| 1053540583 | Jeanette B Reid | Counselor | 6161 9th St N, Suite 201, St Petersburg, FL 33703-1104 | 2009-07-06 |
| 1194982967 | Hector Luis Ortiz | Counselor | 8254 40th Ave N, St Petersburg, FL 33709-3933 | 2008-05-20 |
| 1417078064 | Charmaine Keller | Counselor | 2730 Central Ave, St Petersburg, FL 33712-1153 | 2007-04-02 |
| 1053446823 | Alice Marie Savage | Counselor | 6440 First Ave North, St Petersburg, FL 33710 | 2007-02-22 |
| Find all providers in ST PETERSBURG | ||||
| City | ST PETERSBURG |
| Zip Code | 33733 |
Please comment or provide details below to improve the information on MR. M SHAWN KELLERMAN.
| 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.