JERRY ALAN SUMMERFIELD (NPI# 1073859963) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073859963 |
| Entity Type | Individual |
| Full Name | JERRY ALAN SUMMERFIELD |
| Credential | LMHC |
| Practice Address |
1905 S 25th St Fort Pierce FL 34947-4739 |
| Mailing Address |
1288 Sanchez St Se Palm Bay FL 32909-5565 |
| Practice Telephone | 7725777500 |
| Mailing Telephone | 6819455158 |
| Enumeration Date | 2012-12-20 |
| Last Update Date | 2017-11-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | STATE OF FLORIDA | MH13868 | 01 |
| Street Address |
1905 S 25TH ST |
| City | FORT PIERCE |
| State | FL |
| Zip Code | 34947-4739 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386675767 | Edward W Pelote | Internal Medicine | 1905 S 25th St, Suite 100, Fort Pierce, FL 34947-4739 | 2006-07-05 |
| 1861788036 | Tj Medical LLC | General Practice | 1905 S 25th St, Suite 100, Fort Pierce, FL 34947-4739 | 2011-06-25 |
| 1316233588 | Fp Medical | General Practice | 1905 S 25th St, Suite 100, Fort Pierce, FL 34947-4739 | 2011-06-25 |
| 1003145301 | Holistic Family & Pain Management | Family Medicine | 1905 S 25th St, Ste100, Fort Pierce, FL 34947-4739 | 2009-12-15 |
| 1124160346 | Edward W Pelote Md Pa | Internal Medicine | 1905 S 25th St, Suite 100, Fort Pierce, FL 34947-4739 | 2007-02-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982174215 | Jennifer Denise Williams | Home Health Aide | 1301 South 33rd Street, Fort Pierce, FL 34947 | 2018-11-29 |
| 1811391345 | Shaikh International Medicine, LLC | Internal Medicine | 2504 Acorn St, Suite A, Ft Pierce, FL 34947 | 2014-10-13 |
| 1851728083 | Home Sweet Home of The Treasurwe Coast, Inc. | Assisted Living Facility | 3201 Avenue Q, Fort Pierce, FL 34947 | 2013-10-02 |
| 1831488469 | Gayle Freeman Jones | In Home Supportive Care | 3414 Sloan Rd, Fort Pierce, FL 34947 | 2011-04-05 |
| 1134370927 | Chelsea Lauren Pepera | Licensed Practical Nurse | 1816 South 31st Street, Fort Pierce, FL 34947 | 2008-10-10 |
| 1790971364 | Orion Cardiovascular, IIi | Clinic/Center | 1803 S 25th Street, Ste 1, Ft. Pierce, FL 34947 | 2007-09-18 |
| 1659441236 | Diagnostic Radiology Center of The Treasure Coast | Radiology | 2011 South 25th St, Suite 106, Ft Pierce, FL 34947 | 2006-11-09 |
| 1538245758 | Oswaldo Daniel Benitez Sr. | Family Medicine | 408 South 25th Street, Fort Pierce, FL 34947 | 2006-10-31 |
| 1689786774 | Ajay Kumar Goyal | Radiology | 2011 S 25th St, Suite 106, Fort Pierce, FL 34947 | 2006-08-31 |
| 1649340258 | Ajay K Goyal Md Pa | Radiology | 2011 South 25th St, Suite 106, Ft Pierce, FL 34947 | 2006-11-09 |
| Find all providers in zip 34947 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962024232 | Carolyn Corrina Bethel | Counselor | 2222 Colonial Rd Ste 1002222, Fort Pierce, FL 34950-5309 | 2020-05-10 |
| 1881259323 | Brendalin A Bacon | Counselor | 4713 El Nueva Ave, Fort Pierce, FL 34946-1035 | 2019-05-09 |
| 1114419751 | Ken N Brown | Counselor | 130 S Indian River Dr Ste 301, Fort Pierce, FL 34950-4353 | 2018-05-30 |
| 1881102051 | Toni Marlene Lopez | Counselor | 5202 Melissa Ln, Fort Pierce, FL 34946-9126 | 2018-01-22 |
| 1770930042 | Lucresha Reeves | Counselor | 6804 Santa Clara Blvd, Fort Pierce, FL 34951-1293 | 2016-05-17 |
| 1790170892 | Sade Blackshear | Counselor | 97 Virginia Park Blvd, Fort Pierce, FL 34947-6908 | 2015-04-06 |
| 1750789483 | Lisa Lewis | Counselor | 2814 S Us Highway 1 Ste D-4, Fort Pierce, FL 34982 | 2014-12-11 |
| 1003224338 | Jean-mary Monval | Counselor | 2011 S 25th St Ste 108, Fort Pierce, FL 34947-4795 | 2014-07-30 |
| 1972929834 | Violet Burke | Counselor | 494 Maple Ave, Fort Pierce, FL 34982-5949 | 2014-03-14 |
| 1083043772 | Chaute Thompson | Counselor | 130 S Indian River Dr Ste 202, Fort Pierce, FL 34950-4353 | 2013-11-04 |
| Find all providers in FORT PIERCE | ||||
| City | FORT PIERCE |
| Zip Code | 34947 |
Please comment or provide details below to improve the information on JERRY ALAN SUMMERFIELD.
| 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.