ALIVE & WELL CORP (NPI# 1295245520) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295245520 |
| Entity Type | Organization |
| Organization Name | ALIVE & WELL CORP |
| Practice Address |
10344 Vista Pines Loop Clermont FL 34711-9172 |
| Mailing Address |
Po Box 120682 Clermont FL 34712-0682 |
| Practice Telephone | 8137482912 |
| Mailing Telephone | 8137482912 |
| Enumeration Date | 2017-09-29 |
| Last Update Date | 2017-09-29 |
| Authorized Official Name | MS. MELLISSA LATOYA JAGRUP (PROPRIETER) |
| Authorized Official Telephone | 8137482912 |
| Authorized Official Credential | LMHC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | MH9648 | FL | Agencies |
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
MH9648 | FL | Ambulatory Health Care Facilities |
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
MH9648 | FL | Behavioral Health & Social Service Providers |
| Street Address |
10344 VISTA PINES LOOP |
| City | CLERMONT |
| State | FL |
| Zip Code | 34711-9172 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316546344 | Latricia Richards-smith | Nurse Practitioner | 3301 Hancock Rd, Clermont, FL 34711 | 2020-10-21 |
| 1073130399 | Marissa Johnston | Behavioral Analyst | 355 Citrus Tower Blvd Ste 112, Clermont, FL 34711 | 2020-07-02 |
| 1649839432 | New Foundations Aba Therapy, LLC | Community/Behavioral Health | 4327 S Hwy 27 #176 Clermont, Clermont, FL 34711 | 2019-06-06 |
| 1275006504 | Innovative Medical Management Solutions LLC | Skilled Nursing Facility | 1775 Hooks Street, Clermont, FL 34711 | 2019-01-09 |
| 1851867766 | Chantal P Baptiste | Nurse Practitioner | 2040 Oakley Seaver Dr Ste 300, Clermont, FL 34711 | 2018-10-17 |
| 1346739539 | Jennifer Brennan | Behavior Technician | 365 Citrus Tower Blvd Bldg Ste 106, Clermont, FL 34711 | 2018-05-03 |
| 1689163966 | Chelsea Strickland | Physical Therapy Assistant | 10037 Stockbridge St, Clermont, FL 34711 | 2018-05-02 |
| 1316448921 | Dana Renee Ottalagano | Counselor | 1635 E Highway 50 Ste 204, Clermont, FL 34711 | 2018-02-28 |
| 1306353842 | Center of Change Inc. | General Practice | 235 Citrus Tower Blvd Ste 104, Clermont, FL 34711 | 2018-01-05 |
| 1003328642 | Clermont Radiology LLC | Clinic/Center | 3725 South Highway 27, Suite 104, Clermont, FL 34711 | 2017-11-03 |
| Find all providers in zip 34711 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285246835 | Audrey Simmons | Counselor | 1214 Bowman St, Clermont, FL 34711-3144 | 2020-08-17 |
| 1609330661 | Mary Hamilton | Counselor | 1635 E Hwy 50 Ste 209, Clermont, FL 34711-5034 | 2019-01-24 |
| 1992297667 | Rebecca Caskey | Counselor | 200 E Highland Ave Ste 3, Clermont, FL 34711-2582 | 2018-05-30 |
| 1316448921 | Dana Renee Ottalagano | Counselor | 1635 E Highway 50 Ste 204, Clermont, FL 34711 | 2018-02-28 |
| 1770099830 | Christel Janine Campoy Mamaril | Counselor | 4300 S Hwy 27 Ste 205b, Clermont, FL 34711-8067 | 2017-12-27 |
| 1639613151 | Ginnette Ayala | Counselor | 600 River Birch Ct Apt 522, Clermont, FL 34711-5142 | 2016-12-19 |
| 1932650785 | Grace Gonzalez | Counselor | 201 Hunt St, Apt 1622, Clermont, FL 34711-2484 | 2016-10-17 |
| 1376097451 | Shaleena Lott | Counselor | 1060 W Highway 50 Ste 212, Clermont, FL 34711-2835 | 2016-08-07 |
| 1811349533 | Marygrace Guffey | Counselor | 2530 Citrus Tower Blvd Apt 19105, Clermont, FL 34711-6987 | 2016-07-06 |
| 1174985923 | Andrea Dawson | Counselor | 1450 Blue Horizon Dr, Clermont, FL 34714-4981 | 2016-03-22 |
| Find all providers in CLERMONT | ||||
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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.