GEORGE MALLINCKRODT (NPI# 1801350400) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801350400 |
| Entity Type | Individual |
| Full Name | GEORGE MALLINCKRODT |
| Practice Address |
901 S 62nd Ave Hollywood FL 33023-1848 |
| Mailing Address |
4280 Galt Ocean Dr Apt 9c Ft Lauderdale FL 33308-6105 |
| Practice Telephone | 5617901191 |
| Mailing Telephone | 3052976054 |
| Enumeration Date | 2019-01-28 |
| Last Update Date | 2019-01-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
MH6922 | FL | Behavioral Health & Social Service Providers |
| Street Address |
901 S 62ND AVE |
| City | HOLLYWOOD |
| State | FL |
| Zip Code | 33023-1848 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730175514 | Carol Wartenberg | Psychologist | 901 S 62nd Ave, Hollywood, FL 33023-1848 | 2005-09-27 |
| 1780198333 | Sheera Tzippora Davis | Social Worker | 901 S 62nd Ave, Hollywood, FL 33023-1848 | 2017-11-17 |
| 1922525831 | Brett Engle | Social Worker | 901 S 62nd Ave, Hollywood, FL 33023 | 2017-08-23 |
| 1144649849 | Mary Bell Donahue | Social Worker | 901 S 62nd Ave, Hollywood, FL 33023-1848 | 2014-04-09 |
| 1457683641 | Danielle Lane Montana | Social Worker | 901 S 62nd Ave, Hollywood, FL 33023-1848 | 2010-02-12 |
| 1659508919 | Amy Gardiner | Social Worker | 901 S 62nd Ave, Hollywood, FL 33023-1848 | 2009-06-15 |
| 1447406855 | Anne Grethe Difini | Counselor | 901 S 62nd Ave, Hollywood, FL 33023 | 2008-08-18 |
| 1396787404 | Robin L Schupper | Psychologist | 901 S 62nd Ave, Hollywood, FL 33023-1848 | 2006-06-12 |
| 1972556090 | Suzanne Marie Hennessey | Social Worker | 901 S 62nd Ave, Hollywood, FL 33023-1848 | 2006-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912516139 | Jp Rock Consulting Inc | Nurse Practitioner | 5619 Madison St, Hollywood, FL 33023 | 2020-07-23 |
| 1144789843 | Fausta Mortimer Virgile | Nurse Practitioner | 6640 Dahlia Drive, Miramar, FL 33023 | 2019-03-13 |
| 1245758812 | Lunie Madhere | Family Medicine | 7201 Harbour Blvd, Miramar, FL 33023 | 2017-09-05 |
| 1790203305 | Cassandra Mckenley | Occupational Therapy Assistant | 2931 Utopia Dr, Miramar, FL 33023 | 2017-09-04 |
| 1518497130 | Paradise Senior Center Inc | Clinic/Center | 6240 Pembroke Rd, Miramar, FL 33023 | 2017-06-15 |
| 1710416128 | Optimum Health & Nutrition, LLC | Nutritionist | 3261 Sw 64th Terrace, Miramar, FL 33023 | 2017-06-08 |
| 1275064271 | Esther Ranero Carrazana | Behavioral Analyst | 6412 Sw 21st St, Miramar, FL 33023 | 2017-03-22 |
| 1598208944 | Timothy M Johnson | Contractor | 2637 Pine Tree Dr, Miramar, FL 33023 | 2016-12-02 |
| 1619426392 | Tunlab Home Health Agency Inc. | Day Training, Developmentally Disabled Services | 6724 Camelia Drive, Miramar, FL 33023 | 2016-09-23 |
| 1215385182 | Ruth Giraudy | Behavior Technician | 7912 Biltmore Blvd, Miramar, FL 33023 | 2016-06-01 |
| Find all providers in zip 33023 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912510421 | Michelle Hart | Counselor | 2500 Hollywood Blvd Ste 309, Hollywood, FL 33020-6615 | 2020-08-25 |
| 1124645262 | Natalie Alazrachi, Pa | Counselor | 2421 Hollywood Blvd Ste 2, Hollywood, FL 33020-6605 | 2020-07-05 |
| 1558984526 | Erin Ladwig | Counselor | 3510 Harrison St Apt 7, Hollywood, FL 33021-7428 | 2020-05-25 |
| 1043830425 | Goddess Health & Wellness, LLC | Counselor | 5420 Hollywood Blvd Apt 111, Hollywood, FL 33021-6481 | 2020-04-25 |
| 1255951406 | Eniola Dada | Counselor | 4093 Cascada Cir, Hollywood, FL 33024-8517 | 2020-04-17 |
| 1033748025 | Deborah Blum | Counselor | 1918 Harrison St Ste 203, Hollywood, FL 33020-5066 | 2020-04-02 |
| 1992343727 | Jaime Cowhick | Counselor | 1845 Liberty St Apt 11, Hollywood, FL 33020-2433 | 2019-12-11 |
| 1194360412 | Timothy Leistner | Counselor | 3911 Hollywood Blvd # 3201, Hollywood, FL 33021-6795 | 2019-11-11 |
| 1952943359 | Nikita-charisma Janelle Nicholas | Counselor | 5400 Johnson St, Hollywood, FL 33021-5724 | 2019-10-17 |
| 1003467861 | Gregory Reid Adelstein | Counselor | 3418 Ottawa Ln, Hollywood, FL 33026-4616 | 2019-09-24 |
| Find all providers in HOLLYWOOD | ||||
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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.