Active NPI
Dawn Nicole Carissan, LMHC
- Mental Health Counselor
- Panama City, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 10813
- Practice address
- 525 E 15TH St
Panama City, FL 32405-5412 - Phone
- (850) 522-4485
- Fax
- (850) 522-4484
- NPI assigned
- Jul 6, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | CBHCMS100409 | FL | |
| Mental Health Counselor | 101YM0800X | 10813 | FL | Primary |
Addresses
Primary practice location
525 E 15TH St
Panama City, FL 32405-5412
Mailing address
525 E 15TH St
Panama City, FL 32405-5412
Phone (850) 522-4485
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | dcarissan@lmccares.org | Direct |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10813 | FL | MD | Mental Health Counselor |
| CBHCMS100409 | FL | MD | Case Manager/Care Coordinator |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chrysalis Center, LLC | Current | Accepting new patients | |
| Life Management Center of Northwest Florida Inc | Current | Accepting new patients | |
| Life Management Center of NW FL, Inc. | Current | Accepting new patients | |
| Life Management Center of Northwest Florida Inc | Current | Accepting new patients | |
| Compass Health, Inc | Past | Accepting new patients |
Locations
16869 NE Pear St
Blountstown, FL 32424
Phone (850) 522-4485
310 E Byrd Ave
Bonifay, FL 32425
Phone (850) 522-4485
3800 W Broward Blvd
Ste 100
Ft Lauderdale, FL 33312
4094 Lafayette St
Marianna, FL 32446
Phone (850) 482-7441
2944 Penn Ave
Ste L
Marianna, FL 32448
Phone (850) 526-5500
421 W Oak Ave
Panama City, FL 32401
Phone (850) 215-6007
525 E 15th St
Panama City, FL 32405
Phone (850) 522-4485
311 Williams Ave
Port St Joe, FL 32456
Phone (850) 522-4485
1713 Mahan Dr
Tallahassee, FL 32308
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Fort Lauderdale, FL
- NPI 1700961646
-
- Psychiatry Physician
- Panama City, FL
- NPI 1508854571
-
- Psychiatry Physician
- Blountstown, FL
- NPI 1659301877
-
- Psychiatry Physician
- Bonifay, FL
- NPI 1710912886
-
- Community/Behavioral Health Agency
- Clinton, MO
- NPI 1285619494
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589760000000",
"number": "1134431240",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "525 E 15TH ST",
"city": "PANAMA CITY",
"state": "FL",
"postal_code": "324055412",
"telephone_number": "850-522-4485",
"fax_number": "850-522-4484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 E 15TH ST",
"city": "PANAMA CITY",
"state": "FL",
"postal_code": "324055412",
"telephone_number": "850-522-4485",
"fax_number": "850-522-4484"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARISSAN",
"first_name": "DAWN",
"middle_name": "NICOLE",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-07-06",
"last_updated": "2020-05-18",
"certification_date": "2020-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "FL",
"license": "CBHCMS100409",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "10813",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "dcarissan@lmccares.org",
"affiliation": "N",
"endpointDescription": "email address",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "525 E 15th St",
"city": "Panama City",
"state": "FL",
"country_code": "US",
"postal_code": "324055400",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Panama City, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2020; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.