Healthcare Provider Details

I. General information

NPI: 1679486856
Provider Name (Legal Business Name): KEIRA LYNN DALESSIO RMHCI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 S FEDERAL HWY STE C
DELRAY BEACH FL
33483-3321
US

IV. Provider business mailing address

5400 BROKEN SOUND BLVD NW APT 623 APT 623
BOCA RATON FL
33487-3728
US

V. Phone/Fax

Practice location:
  • Phone: 561-408-1098
  • Fax:
Mailing address:
  • Phone: 732-850-8879
  • Fax: 732-850-8879

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number35428
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: