Ingrid Gallimore
Individual provider Active NPI Mental Health Counselor · Tallahassee, FL
NPI 1194576397 · NPPES record last updated Mar 27, 2024
Key facts
- NPI
- 1194576397
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- SW22652 (FL)
- Practice address
- 2892 E Park Ave
Tallahassee, FL 32301-3445 - Phone
- (229) 474-1517
- NPI assigned
- Mar 27, 2024
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250128004155 | FL | Practitioner - Clinical Social Worker | 9537698089 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW22652 | FL | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PA | Mental Health | Current |
Accepting new patients |
Locations
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | SW22652 | FL | Yes |
Addresses
Primary practice location
2892 E Park Ave
Tallahassee, FL 32301-3445
Mailing address
2892 E Park Ave
Tallahassee, FL 32301-3445
Phone (229) 474-1517
Other providers in Tallahassee, FL
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- Gainesville Vamc
- Gainesville Vamc
- Jazzime D Gainous
- Jensen Galetta
- Mary A Gallo
- Ginger Len Galloway
- William Charles Gamberino
- Mary I Gamble
- Michelle Gamble
All providers in Tallahassee, FL · Mental Health Counselor in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 27, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.