MID STATE MENTAL HEALTH ASSESSMENT INC (NPI# 1215262977) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215262977 |
| Entity Type | Organization |
| Organization Name | MID STATE MENTAL HEALTH ASSESSMENT INC |
| Practice Address |
7052 Annunciation Circle Suite 329 Ave Maria FL 34142-0000 |
| Mailing Address |
5819 Plymouth Pl Ave Maria FL 34142-9586 |
| Practice Telephone | 2393524004 |
| Mailing Telephone | 2393524004 |
| Enumeration Date | 2009-10-13 |
| Last Update Date | 2013-02-06 |
| Authorized Official Name | DR. BRUCE EDWARD MALCOLM (PRESIDENT) |
| Authorized Official Telephone | 2393524004 |
| Authorized Official Credential | PSY.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | PY8461 | FL | Behavioral Health & Social Service Providers |
| Street Address |
7052 ANNUNCIATION CIRCLE SUITE 329 |
| City | AVE MARIA |
| State | FL |
| Zip Code | 34142-0000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619432622 | Gabriels House of Care Fl. LLC | Acupuncturist | 212 South First St., Immokalee, FL 34142 | 2019-02-04 |
| 1851662472 | Seminole Tribe of Florida | Clinic/Center | 1120 S. First Street, Immokalee, FL 34142 | 2012-01-13 |
| 1881849826 | Michael Kane | Dentist | 1013 W. Main St., Unit 6a, Immokalee, FL 34142 | 2008-11-18 |
| 1699870485 | Jane J Darien | Social Worker | 425 North First St, Immokalee, FL 34142 | 2006-09-14 |
| 1659873891 | Dayna Sue Shull | Specialist/Technologist | 5050 Ave Maria Blvd, Ave Maria, FL 34142 | 2018-03-04 |
| 1457881922 | Immokalee Dental P.a. | Dentist | 1013 W. Main St., Unit 6a, Immokalee, FL 34142 | 2017-06-15 |
| 1063687838 | Alexandra Bianca Sarac | Pediatrics | 1441 Heritage Blvd, Immokalee, FL 34142 | 2008-04-23 |
| 1942391099 | Shameem Tamton | Pediatrics | 1454 Madison Ave W, Immokalee, FL 34142 | 2006-09-27 |
| 1194343194 | Laury Garcia | Social Worker | 3511 Carson Lakes Cir, Immokalee, FL 34142-2092 | 2020-07-07 |
| 1558399550 | Georges Etienne Quesnel | Obstetrics & Gynecology | Marion E Fether Medical Center, 1454 Madison Ave. W, Immokalee, FL 34142-2200 | 2006-06-29 |
| Find all providers in zip 34142 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376144774 | Jennifer Mcmanus | Psychologist | 4143 San Juan Ave, Jacksonville, FL 32210-3333 | 2020-11-03 |
| 1992304711 | Thomas Francis Ryan | Psychologist | 1015 Sonesta Ave, Brandon, FL 33511-6658 | 2020-10-22 |
| 1912506924 | Emily F. Hoon, Phd, Pllc | Psychologist | 2531 Nw 41st Street, Suite C, Gainesville, FL 32606-7490 | 2020-10-21 |
| 1447866405 | Daniel Martinez | Psychologist | 4765 W Atlantic Ave, Delray Beach, FL 33445-3838 | 2020-09-16 |
| 1134731367 | North Florida Neuropsychology, LLC | Psychologist | 1614 Mahan Center Blvd Ste 104, Tallahassee, FL 32308-5475 | 2020-08-19 |
| 1215547153 | Ellen Frances Price Phd | Psychologist | 7025 Beracasa Way Ste 102c, Boca Raton, FL 33433-3428 | 2020-08-05 |
| 1811515745 | Sarah Amelia Sanon | Psychologist | 10381 Sw 9th Ln, Pembroke Pines, FL 33025-3585 | 2020-07-07 |
| 1720606718 | Carolina Montalvo | Psychologist | 480 Ne 30th St Apt 1606, Miami, FL 33137-4337 | 2020-07-07 |
| 1689291833 | Bridget Cabibi | Psychologist | 10700 Nw 66th St Apt 512, Doral, FL 33178-5508 | 2020-07-02 |
| 1912524414 | Infinity Doctors Inc. | Psychologist | 9821 E Bay Harbor Dr Apt 401, Bay Harbor Islands, FL 33154-1868 | 2020-06-30 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MID STATE MENTAL HEALTH ASSESSMENT INC.
| 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.