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General NPI Number Information
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NPI Number | 1952660938
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Entity Type | Individual
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Provider Name | JANIE MADONNA DEBLAUWE LMHC, RN
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Gender | Female
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Dates
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Enumeration Date | 05/10/2012
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Last Update Date | 01/15/2025
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Provider Practice Location Address
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Address Line | 907 SE CENTRAL PKWY
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City | STUART
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State | FL
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Zip | 34994-3904
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Country | US
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Telephone | 772-210-4362
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Fax |
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Provider Business Mailing Address
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Address Line | 4648 SE SALVATORI RD
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City | STUART
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State | FL
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Zip | 34997-8271
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Country | US
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Telephone | 941-526-5133
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN9425217
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH11837
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License Number State | FL
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