DECARLOS SCIPPIO (NPI# 1093186777) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093186777 |
| Entity Type | Individual |
| Full Name | DECARLOS SCIPPIO |
| Practice Address |
619 Sw Baya Drive Suite 102 Lake City FL 32025 |
| Mailing Address |
226 Sw Pine Forest Ct Lake City FL 32024 |
| Practice Telephone | 3863448355 |
| Mailing Telephone | 3863448355 |
| Enumeration Date | 2015-10-07 |
| Last Update Date | 2018-08-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | DRIVER LICENSE | S100-171-87-297-0 | 01 |
| Street Address |
619 SW BAYA DRIVE SUITE 102 |
| City | LAKE CITY |
| State | FL |
| Zip Code | 32025 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801438353 | Jennifer Bennett | Pharmacist | 347 Sw Main Blvd Suite 102, Lake City, FL 32025 | 2019-10-16 |
| 1700352838 | Robert J Sansouci IIi IIi | Physical Therapy Assistant | 560 Sw Mcfarlane Ave, Lake City, Fl, 32025, Lake City, FL 32025 | 2018-10-16 |
| 1316442783 | Emily Bailey | Developmental Therapist | 2126 Sw Sisters Welcome Rd, Lake City, FL 32025 | 2018-03-28 |
| 1811446370 | Michelle Hart | Behavioral Analyst | 260 S. Marion Avenue, Bldg. A, Suite 135, Lake City, FL 32025 | 2016-09-26 |
| 1922467646 | Irene Aponte Moreno | Nurse Practitioner | 440 Sw Perimeter Glen, Lake City, FL 32025 | 2016-02-23 |
| 1497132476 | Jamecia Legree | Registered Nurse | 800 Sw Symphony Loop, Bldg 15 Apt 204, Lake City, FL 32025 | 2015-04-29 |
| 1306249149 | Mercy Home Assisted Living Facility LLC | Assisted Living Facility | 184 S.e. Beech Street, Lake City, FL 32025 | 2014-10-08 |
| 1598174344 | Karen Mcdonald | Developmental Therapist | 4523 Se County Road 252, Lake City, FL 32025 | 2014-08-06 |
| 1275944126 | Mohammad Ali Faisal Mdpa | Specialist | 1283 Sw State Rd 47, Ste 104, Lake City, FL 32025 | 2014-05-14 |
| 1003226887 | Tiffany Denise Watson | Nurse's Aide | 733 Sw Cr 242-a, Lake City, FL 32025 | 2014-05-02 |
| Find all providers in zip 32025 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598366171 | Neurodiverse Ability Services LLC | Counselor | 608 Sw Marvin Burnett Rd, Lake City, FL 32025-4918 | 2020-11-02 |
| 1538715016 | Vanessa George | Counselor | 930 Ne Joe Coney Ter, Lake City, FL 32055-1636 | 2019-08-12 |
| 1811399439 | Michael Ortiz | Counselor | 311 Se Mill Creek Ct, Lake City, FL 32025-3912 | 2014-09-25 |
| 1124439351 | Tynette Jordan | Counselor | 708 N.w Wilson St., Lake City, FL 32055 | 2014-05-09 |
| 1730426347 | Jesenia Minniefield | Counselor | 136 Nw Veterans St, Lake City, FL 32055-3900 | 2013-01-16 |
| 1780957050 | Daphne O Cunningham | Counselor | 922 Sw Baya Dr, Lake City, FL 32025-4209 | 2012-02-17 |
| 1841585874 | Vadonna Benson Bartell | Counselor | 711 Bartells Rd, Lake City, SC 29560-7564 | 2011-06-17 |
| 1417100140 | Resolutions Health Alliance, P.a. | Counselor | 297 Nw Hillsboro St, Lake City, FL 32055-3320 | 2008-10-28 |
| 1093974164 | Robert Reynierson | Counselor | 439 Sw Michigan Street, Lake City, FL 32025-0440 | 2008-06-04 |
| 1326206012 | Julie Melvin | Counselor | 761 Se Defender Dr, Lake City, FL 32025-6367 | 2008-05-29 |
| Find all providers in LAKE CITY | ||||
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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.