Active NPI
Nisy Itty, M.H.S, CRC
- Counselor
- Winter Park, FL
National Provider Identifier
1104188655
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 00111018
- Practice address
- 315 N Lakemont Ave
Suite B
Winter Park, FL 32792-3205 - Phone
- (407) 830-6412
- Fax
- (407) 830-8413
- NPI assigned
- Jun 11, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 00111018 | FL | Primary |
Addresses
Primary practice location
315 N Lakemont Ave
Suite B
Winter Park, FL 32792-3205
Mailing address
453 Bridge Creek Blvd
Ocoee, FL 34761-4726
Phone (321) 217-3641
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00111018 | FL | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339372800000",
"number": "1104188655",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "453 BRIDGE CREEK BLVD",
"city": "OCOEE",
"state": "FL",
"postal_code": "347614726",
"telephone_number": "321-217-3641"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "315 N LAKEMONT AVE",
"address_2": "SUITE B",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327923205",
"telephone_number": "407-830-6412",
"fax_number": "407-830-8413"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ITTY",
"first_name": "NISY",
"name_prefix": "Ms.",
"credential": "M.H.S, CRC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-06-11",
"last_updated": "2012-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "FL",
"license": "00111018",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winter Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.