Healthcare Provider Details

I. General information

NPI: 1629781919
Provider Name (Legal Business Name): CAVALLARO COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2023
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 PRIMERA BLVD STE 145
LAKE MARY FL
32746-2130
US

IV. Provider business mailing address

4145 CALEDONIA AVE
APOPKA FL
32712-6048
US

V. Phone/Fax

Practice location:
  • Phone: 407-279-0922
  • Fax:
Mailing address:
  • Phone: 407-900-5663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MELANIE CAVALLARO
Title or Position: OWNER/PROVIDER
Credential: LMHC
Phone: 407-900-5663