Individual provider Active NPI

Dawn Nicole Carissan, LMHC

  • Mental Health Counselor
  • Panama City, FL
National Provider Identifier
1134431240
Registry record updated May 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
10813 Issued in FL
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

Updated by the provider on May 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240216002419 FL Practitioner - Mental Health Counselor 0143664276 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10813FLMDMental Health Counselor
CBHCMS100409FLMDCase Manager/Care Coordinator

Practice roles

OrganizationSpecialtyStatusNew patients
Chrysalis Center, LLC CurrentSince Aug 15, 2025 Accepting new patients
Life Management Center of Northwest Florida Inc CurrentSince Jan 17, 2024 Accepting new patients
Life Management Center of NW FL, Inc. Current Accepting new patients
Life Management Center of Northwest Florida Inc CurrentSince Jan 17, 2024 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.

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

Verify at the official NPI Registry.