MRS. TAKEISHA MITCHELL-INGRAM (NPI# 1801312830) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801312830 |
| Entity Type | Individual |
| Full Name | MRS. TAKEISHA MITCHELL-INGRAM |
| Practice Address |
130 S Indian River Dr Ste 202 Fort Pierce FL 34950-4353 |
| Mailing Address |
1778 Sw Newport Isles Blvd Port St Lucie FL 34953-4590 |
| Practice Telephone | 7729059030 |
| Mailing Telephone | 5618181101 |
| Enumeration Date | 2017-08-22 |
| Last Update Date | 2017-08-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD1600X |
Clinic/Center Specialization: Developmental Disabilities |
Ambulatory Health Care Facilities |
| Street Address |
130 S INDIAN RIVER DR STE 202 |
| City | FORT PIERCE |
| State | FL |
| Zip Code | 34950-4353 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083043772 | Chaute Thompson | Counselor | 130 S Indian River Dr Ste 202, Fort Pierce, FL 34950-4353 | 2013-11-04 |
| 1740892934 | Sassoon Psychiatric Services, P.C. | Psychiatry & Neurology | 130 S Indian River Dr Ste 202, Fort Pierce, FL 34950-4353 | 2020-08-19 |
| 1285131664 | Calvary Home Health Agency | Home Health | 130 S Indian River Dr Ste 202, Fort Pierce, FL 34950-4353 | 2018-04-11 |
| 1962909333 | Christine Marie Commond | Home Health | 130 S Indian River Dr Ste 202, Fort Pierce, FL 34950-4353 | 2018-04-11 |
| 1275042483 | Base Medical Supply Inc. | Durable Medical Equipment & Medical Supplies | 130 S Indian River Dr Ste 202, Fort Pierce, FL 34950-4353 | 2017-09-20 |
| 1063867828 | Premier Plus Medical Supplies Inc | Durable Medical Equipment & Medical Supplies | 130 S Indian River Dr Ste 202, Fort Pierce, FL 34950-4353 | 2016-04-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659853018 | New Day Counseling & Wellness, LLC | Clinic/Center | 130 S Indian River Drive Suite 202, Fort Pierce, FL 34950 | 2018-09-03 |
| 1548749351 | Jaber's Pharmacy, Inc. | Pharmacy | 2210 Orange Ave, Fort Pierce, FL 34950 | 2018-08-13 |
| 1386139699 | Pas Substance Abuse, Inc. | Substance Abuse Rehabilitation Facility | 2017 Avenue D, Fort Pierce, FL 34950 | 2018-06-28 |
| 1629573134 | Southeastern Dme LLC | Durable Medical Equipment & Medical Supplies | 200 S Indian River Dr Ste 300, Fort Pierce, FL 34950 | 2018-03-27 |
| 1962903666 | Serenity Dme LLC | Durable Medical Equipment & Medical Supplies | 111 N 2nd St Ste 101, Fort Pierce, FL 34950 | 2018-02-27 |
| 1417463068 | Ryan Nippes | Counselor | 1302 N Lawnwood Cr, Suite B, Fort Pierce, FL 34950 | 2017-12-19 |
| 1639685282 | Valencia Worrell | Counselor | 1302 N Lswnwood Cr, Suite B, Fort Pierce, FL 34950 | 2017-12-19 |
| 1194173153 | Angel French | Massage Therapist | 101 North Us1, Suite 117, Fort Pierce, FL 34950 | 2016-06-01 |
| 1780052951 | Alison Hess | Physician Assistant | 1700 S. 23rd St, Fort Pierce, FL 34950 | 2015-09-04 |
| 1629329784 | Dr. Rhaina A Smeds, Psyd Inc. | Psychologist | 100 Ave A, Ste 2d, Ft. Pierce, FL 34950 | 2012-09-28 |
| Find all providers in zip 34950 | ||||
| Taxonomy Code | 261QD1600X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Developmental Disabilities |
| An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255947834 | Changing Strides Community Services Inc | Clinic/Center | 130 S Indian River Dr Ste 242, Fort Pierce, FL 34950-4353 | 2020-09-19 |
| 1982220695 | Peace of Mind Homecare Solutions of The Palm Beaches LLC | Clinic/Center | 412 Se Faith Ter, Fort Pierce, FL 34983-3242 | 2020-06-18 |
| 1720623051 | Nikeshas Loving Touch Inc | Clinic/Center | 1800 Oleander Blvd, Fort Pierce, FL 34950-8157 | 2019-11-11 |
| 1265083232 | Leona M. Kelly | Clinic/Center | 710 N 20th St Apt A, Fort Pierce, FL 34950-6105 | 2019-09-21 |
| 1134602691 | Christy Woods | Clinic/Center | 3209 Hibiscus Ave, Fort Pierce, FL 34947-7240 | 2018-09-11 |
| 1518449206 | Care One Support LLC | Clinic/Center | 2609 Navajo Ave, Fort Pierce, FL 34946-1729 | 2018-08-30 |
| 1285128488 | A and R Non Emergency Medical Transportation Service LLC | Clinic/Center | 2140 N Us Highway 1, Fort Pierce, FL 34946-8993 | 2018-06-20 |
| 1740770528 | Empowering Supportive Care Inc | Clinic/Center | 2620 S 29th St Apt B, Fort Pierce, FL 34981-5592 | 2018-05-16 |
| 1063920882 | Gayleann King | Clinic/Center | 2901 Avenue D, Fort Pierce, FL 34947-2663 | 2018-01-15 |
| 1285147207 | A Caring Alternative Healthcare Inc | Clinic/Center | 2134 N Us Highway 1, Fort Pierce, FL 34946-8993 | 2017-11-13 |
| Find all providers in FORT PIERCE | ||||
| City | FORT PIERCE |
| Zip Code | 34950 |
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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.