Sacred Mind Psychiatry LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

SACRED MIND PSYCHIATRY LLC

Practice address

4255 SW Cambridge GLN
Lake City, FL 32024-3431

Phone

(386) 623-1198

NPI assigned

Aug 22, 2025

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michlalona Scippio, PMHNP

Title

Arnp

Phone

(386) 623-1198

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michalona Scippio

  • Psychiatric/Mental Health Nurse Practitioner
  • Lake Mary, FL
  • NPI 1720850712
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1755820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755993600000",
    "number": "1003794678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2666",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320562666",
            "telephone_number": "386-623-1198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4255 SW CAMBRIDGE GLN",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320243431",
            "telephone_number": "386-623-1198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SACRED MIND PSYCHIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-22",
        "last_updated": "2025-08-24",
        "certification_date": "2025-08-24",
        "status": "A",
        "authorized_official_last_name": "SCIPPIO",
        "authorized_official_first_name": "MICHLALONA",
        "authorized_official_title_or_position": "ARNP",
        "authorized_official_telephone_number": "386-623-1198",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeannette H. Runyon, SLP
• Shane Renee Russell, MS CCC-SLP
• Michelle Russo
• Jung Ho Ryu, PHD
• Pedro Alberto Sabillon, LPN
• Sacred Wings Counseling, LLC
• Jean Denis Saintvil, SPEECH THERAPIST-CF
• Salem Homes of Florida, Inc.
• Salem Villages MRDD, Inc.
• Rigen Pamin Saltivan, OD

• Adult Mental Health Clinic/Center in Lake City, FL
• Providers in Lake City, FL by specialty
• Adult Mental Health Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.