Healthcare Provider Details

I. General information

NPI: 1962176412
Provider Name (Legal Business Name): DELLANIE ALMOND LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2021
Last Update Date: 04/05/2023
Certification Date: 04/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4680 EVELYN ST
PACE FL
32571-1557
US

IV. Provider business mailing address

4680 EVELYN ST
PACE FL
32571-1557
US

V. Phone/Fax

Practice location:
  • Phone: 850-418-0753
  • Fax:
Mailing address:
  • Phone: 850-418-0753
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberSW13330
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number8469
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number17739
License Number StateLA
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW13330
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: