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General NPI Number Information
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NPI Number | 1467268425
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Entity Type | Individual
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Provider Name | ALESSANDRA NICOLE MACCA LMHC
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Gender | Female
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Dates
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Enumeration Date | 12/05/2024
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 4244 CENTRAL AVE
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City | SAINT PETERSBURG
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State | FL
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Zip | 33711-1140
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Country | US
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Telephone | 727-308-6094
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Fax |
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Provider Business Mailing Address
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Address Line | 6465 142ND AVE N APT U103
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City | CLEARWATER
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State | FL
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Zip | 33760-2767
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Country | US
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Telephone | 860-882-4862
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH24652
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License Number State | FL
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