MEDICARE: JAMESON DEPAOLA MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	IMH29142	FL

General Provider Information

NPI Number	:	1972440808
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMESON DEPAOLA MS

Provider Business Mailing Address
First Line	:	1089 WINDING PINES CIR UNIT 205
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33909-8759
Country	:	US
Telephone Number	:	239-900-4979
Fax Number	:

Provider Business Practice Location Address
First Line	:	3208 CHIQUITA BLVD S STE 204
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33914-4267
Country	:	US
Telephone Number	:	941-451-7506
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/29/2026
Last Update Date	:	04/29/2026

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