Healthcare Provider Details

I. General information

NPI: 1578068565
Provider Name (Legal Business Name): DEVON STAROPOLI LMHC, M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2018
Last Update Date: 04/13/2021
Certification Date: 03/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 NORTHLAKE BLVD APT 2138
ALTAMONTE SPRINGS FL
32701
US

IV. Provider business mailing address

321 NORTHLAKE BLVD APT 2138
ALTAMONTE SPRINGS FL
32701-5257
US

V. Phone/Fax

Practice location:
  • Phone: 195-460-8122
  • Fax:
Mailing address:
  • Phone: 195-460-8122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH15776
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: