MRS. LIZA CRISTIN PROVENZANO (NPI# 1427203736) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427203736 |
| Entity Type | Individual |
| Full Name | MRS. LIZA CRISTIN PROVENZANO |
| Credential | LMHC |
| Practice Address |
13400 Sutton Park Dr S Suite 1504 Jacksonville FL 32224-0236 |
| Mailing Address |
912 Collinswood Dr W Jacksonville FL 32225-0861 |
| Practice Telephone | 9045685826 |
| Mailing Telephone | 9045685826 |
| Enumeration Date | 2008-12-01 |
| Last Update Date | 2015-07-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
MH9038 | FL | Behavioral Health & Social Service Providers |
| Street Address |
13400 SUTTON PARK DR S SUITE 1504 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32224-0236 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255331237 | Randi Most | Clinical Neuropsychologist | 13400 Sutton Park Dr S, Suite 1504, Jacksonville, FL 32224-0236 | 2005-07-30 |
| 1588122188 | Rayna Vaught Godfrey | Psychologist | 13400 Sutton Park Dr S, Suite 1504, Jacksonville, FL 32224-0237 | 2019-03-04 |
| 1457755530 | Healing Hearts Therapy LLC | Counselor | 13400 Sutton Park Dr S, Suite 1001-4/5, Jacksonville, FL 32224-0236 | 2014-10-17 |
| 1093128878 | Haley Dawson | Counselor | 13400 Sutton Park Dr S, Ste 1001, Jacksonville, FL 32224-0236 | 2014-06-09 |
| 1093099970 | Theresa Maria Dinuzzo | Psychologist | 13400 Sutton Park Dr S, Suite 1504, Jacksonville, FL 32224-0236 | 2011-10-10 |
| 1235455239 | Providential Health Care, Inc | In Home Supportive Care | 13400 Sutton Park Dr S, Suite 1101, Jacksonville, FL 32224-0236 | 2010-04-15 |
| 1295965176 | Ian Seth Otto | Speech-Language Pathologist | 13400 Sutton Park Dr S, Suite 1101, Jacksonville, FL 32224-0236 | 2009-07-25 |
| 1699948547 | Sharon A Knapp | Massage Therapist | 13400 Sutton Park Dr S, Suite 1502, Jacksonville, FL 32224-0236 | 2008-04-10 |
| 1770788390 | Susan N Young Inc | Clinical Neuropsychologist | 13400 Sutton Park Dr S, Suite 1504, Jacksonville, FL 32224-0236 | 2007-06-15 |
| 1215039656 | Susan Nilette Young | Clinical Neuropsychologist | 13400 Sutton Park Dr S, Suite 1504, Jacksonville, FL 32224-0236 | 2006-09-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356974372 | Noelle Parker | Specialist/Technologist | 1 Unf Drivve, Jacksonville, FL 32224 | 2020-02-18 |
| 1124685102 | Charcy Rene Stiller | Specialist/Technologist | 1 Unf Dr., Jacksonville, FL 32224 | 2019-05-24 |
| 1265097513 | Mayo Clinic Jacksonville | Ambulance | 13970 Zumbro Dr, Jacksonville, FL 32224 | 2019-05-02 |
| 1639681471 | Brigantti Anesthesia & Spine Care | Clinic/Center | 1361 13th Ave South Suite #210, Jacksonville, FL 32224 | 2017-11-02 |
| 1093240061 | Beric Emilio Berlioz | Anesthesiology | 4500 San Pablo Rd S # J, Jacksonville, FL 32224 | 2017-04-26 |
| 1609240746 | Matthew James Dailey | Nurse Anesthetist, Certified Registered | 2500 San Pablo Rd S, Jacksonville, FL 32224 | 2015-11-29 |
| 1003299603 | Upscale Personal Care Home | Assisted Living Facility | 4375 Autumn River Road, Jacksonville, FL 32224 | 2015-07-01 |
| 1629459375 | Bellanid Fonseca | Social Worker | 3694 Summerlin Ln E, Jacksonville, FL 32224 | 2015-06-17 |
| 1164840500 | Nicholas Scotto | Physical Therapist | 11555 Central Pkwy Ste 1104, Jacksonville, FL 32224 | 2014-04-02 |
| 1497093454 | Quicker Care Urgent Care | Point of Service | 13770 Beach Blvd., Unit # 4, Jacksonville, FL 32224 | 2013-01-27 |
| Find all providers in zip 32224 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134720519 | Ashley Harms | Counselor | 4070 Herschel St Ste 1, Jacksonville, FL 32210-2239 | 2020-11-03 |
| 1902418684 | Molly Ann Burkhardt | Counselor | 5776 Saint Augustine Rd # 8030, Jacksonville, FL 32207-8046 | 2020-08-23 |
| 1194335638 | Aiteria Green | Counselor | 9713 Bridgeway Ave, Jacksonville, FL 32222-2913 | 2020-08-07 |
| 1053920116 | Barbara Burden | Counselor | 209 N Carole Dr, Jacksonville, NC 28546-4845 | 2020-07-24 |
| 1790393973 | Kelley Holladay | Counselor | 1782 Plantation Oaks Dr, Jacksonville, FL 32223-5010 | 2020-07-14 |
| 1629696646 | Mary Ann Caldwell | Counselor | 2496 Northwoods Dr., Jacksonville, NC 28540 | 2020-07-07 |
| 1447877709 | Quendria Johnson-kerns | Counselor | 200 Zonnie Ln, Jacksonville, NC 28540-9729 | 2020-07-02 |
| 1467077164 | Shanna Horan | Counselor | 13500 Sutton Park Dr S Ste 702, Jacksonville, FL 32224-5290 | 2020-06-09 |
| 1720602527 | Shannon E Raikes | Counselor | 13990 Bartram Park Blvd Unit 209, Jacksonville, FL 32258-5543 | 2020-06-08 |
| 1750905253 | Kathlena N Reed | Counselor | 4131 University Blvd S Fl 32216, Jacksonville, FL 32216-4326 | 2020-06-01 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32224 |
Please comment or provide details below to improve the information on MRS. LIZA CRISTIN PROVENZANO.
| 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.