DIANE HERIBACKA (NPI# 1700169752) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700169752 |
| Entity Type | Individual |
| Full Name | DIANE HERIBACKA |
| Credential | LMFT |
| Practice Address |
6700 S Washington Ave Titusville FL 32780-8050 |
| Mailing Address |
400 Sheridan Rd Melbourne FL 32901-3122 |
| Practice Telephone | 3217225200 |
| Mailing Telephone | 3217225200 |
| Enumeration Date | 2011-09-26 |
| Last Update Date | 2016-08-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | 35001728A | IN | Behavioral Health & Social Service Providers |
| Street Address |
6700 S WASHINGTON AVE |
| City | TITUSVILLE |
| State | FL |
| Zip Code | 32780-8050 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952476541 | Remigio C. Villegas Jr. | Psychiatry & Neurology | 6700 S Washington Ave, Titusville, FL 32780-8050 | 2006-11-21 |
| 1306275524 | Mary Beth Goodman | Counselor | 6700 S Washington Ave, Titusville, FL 32780-8050 | 2013-11-07 |
| 1932322732 | Don Allyn Lenox | Social Worker | 6700 S Washington Ave, Titusville, FL 32780-8050 | 2007-04-10 |
| 1750423851 | Patricia Lochnicht | Counselor | 6700 S Washington Ave, Titusville, FL 32780-8050 | 2007-02-13 |
| 1366584138 | Paula Sumner | Counselor | 6700 S Washington Ave, Titusville, FL 32780-8050 | 2007-02-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700400207 | Elizabeth Hardin | Chiropractor | Florida Sports and Spinal Rehab, 3910 S. Washington Ave., Titusville, FL 32780 | 2020-06-01 |
| 1477033934 | Eye Doctors Optical Outlets, Pa | Optometrist | 2510 S Washington, Suite 140, Titusville, FL 32780 | 2018-08-15 |
| 1427566819 | Marlene Joyce Rosenzweig | Home Health | 1415 Thornton Avenue, Titusville, FL 32780 | 2018-01-19 |
| 1962913681 | Medfast Urgent Care Center, LLC | Clinic/Center | 1840 South Washington Ave, Titusville, FL 32780 | 2017-10-20 |
| 1982122586 | Annie Durand | Physical Therapist | 4352 Derbyshire Drive, Titusville, FL 32780 | 2017-09-03 |
| 1205352341 | Hearing Healthcare Solutions, Inc. | Hearing Instrument Specialist | 2625 Barna Ave, Suite J, Titusville, FL 32780 | 2017-08-21 |
| 1134663669 | Laura Starks | Behavior Technician | 1000 Tree Lane Apt H, Titusville, FL 32780 | 2016-12-19 |
| 1235500471 | Comfortable Care Dental Health Professionals, Pa | Dentist | 3135 Columbia Blvd, Suite 100, Titusville, FL 32780 | 2015-10-14 |
| 1174994412 | Amanda Howell | Counselor | 5280 Watermill Lane Apt 305, Titusville, FL 32780 | 2015-10-13 |
| 1609267939 | Bykota Acupuncture | Acupuncturist | 1007 South Washington Ave, Titusville, FL 32780 | 2015-02-09 |
| Find all providers in zip 32780 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316548365 | New Leaf Therapy, LLC | Marriage & Family Therapist | 2331 Nw 69th Ct, Fort Lauderdale, FL 33309-1438 | 2020-11-05 |
| 1114528460 | Matthew Edward Winkles | Marriage & Family Therapist | 1215 E Robinson St, Orlando, FL 32801-2115 | 2020-11-03 |
| 1114526670 | Westside Therapy | Marriage & Family Therapist | 4313 Golfers Cir E, Palm Beach Gardens, FL 33410-4609 | 2020-10-25 |
| 1356940811 | Alexandra Weisz | Marriage & Family Therapist | 3451 Ne 1st Ave Apt M201, Miami, FL 33137-4052 | 2020-10-25 |
| 1093314692 | Rothschild Counseling and Consulting, LLC | Marriage & Family Therapist | 820 E. Park Ave, Suite F 100, Tallahassee, FL 32301 | 2020-10-23 |
| 1831797729 | Becky Aaland | Marriage & Family Therapist | 600 Starkey Rd Apt 1307, Largo, FL 33771-2852 | 2020-10-13 |
| 1275149148 | Ebony Blue-fields | Marriage & Family Therapist | 2933 Nw 170th St, Miami Gardens, FL 33056-4323 | 2020-09-16 |
| 1003420118 | Gisela Karina Ludman Rojzman | Marriage & Family Therapist | 2542 Ne 206th Ter, Miami, FL 33180-1347 | 2020-09-04 |
| 1881208304 | Zuwania Lynette Smith | Marriage & Family Therapist | 2312 Mayo St, Hollywood, FL 33020-6240 | 2020-09-02 |
| 1699388892 | Damon Pourtahmaseb-sasi | Marriage & Family Therapist | 761 Ne 199th St Apt 204, Miami, FL 33179-3067 | 2020-08-26 |
| Find all providers with the same taxonomy | ||||
| City | TITUSVILLE |
| Zip Code | 32780 |
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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.