Healthcare Provider Details

I. General information

NPI: 1265737001
Provider Name (Legal Business Name): HEATHER CAIAZZO MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2011
Last Update Date: 09/11/2025
Certification Date: 02/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 SE OCEAN AVE STE 340
STUART FL
34996-3271
US

IV. Provider business mailing address

900 SE OCEAN AVE STE 340
STUART FL
34996-3271
US

V. Phone/Fax

Practice location:
  • Phone: 772-220-3439
  • Fax: 772-220-3484
Mailing address:
  • Phone: 772-220-3439
  • Fax: 772-220-3484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number39285
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: