Alicia Anne Divico, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH11494 Issued in FL

Practice address

550 N Reo St Ste 240
Tampa, FL 33609-1062

Phone

(813) 435-3060

NPI assigned

Nov 15, 2012

Last updated

Mar 31, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Personal Wellness Solutions, LLC

  dba Personal Wellness Solutions

  • Mental Health Counselor
  • Tampa, FL
  • NPI 1639851512
  Medicare reassignment NPD Authorized official
• Personal Wellness Solutions, P.a.

  • Mental Health Counselor
  • Tampa, FL
  • NPI 1164827838
  NPD Authorized official

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648684800000",
    "number": "1013251180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4511 N HIMES AVE",
            "address_2": "SUITE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336147074",
            "telephone_number": "813-546-0585",
            "fax_number": "813-449-4421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 N REO ST STE 240",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336091062",
            "telephone_number": "813-435-3060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4511 N Himes Ave",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336147074",
            "country_code": "US",
            "telephone_number": "813-546-0585",
            "fax_number": "813-449-4421",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIVICO",
        "first_name": "ALICIA",
        "middle_name": "ANNE",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH11494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007383800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph Dituri, PHD(C), CHT
• Rebecca Edgeworth Ditwiler, P.T.
• Diverse Behavioral Services Corp
• Diversified Medical Equipment
• Diversified Medical Health Inc
• Linda Louise Divico, RN
• Divine Hands Home Care LLC
• Divine Home Health Care, Inc
• Divine Home Health Group, Inc
• Divine Inspiration LLC

• Mental Health Counselor in Tampa, FL
• Providers in Tampa, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.