Madeline Grace Oberg

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

IMH20603 Issued in FL

Practice address

4421 NW 39TH Ave Ste 3
Gainesville, FL 32606-7221

Phone

(352) 448-1614

NPI assigned

Jan 26, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Kollao Care LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Gainesville, FL
  • NPI 1598483059
  NPD Authorized official

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

{
    "created_epoch": "1611619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1205426046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25177 NW 176TH AVE",
            "city": "HIGH SPRINGS",
            "state": "FL",
            "postal_code": "326439878",
            "telephone_number": "352-448-1614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4421 NW 39TH AVE STE 3",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326067221",
            "telephone_number": "352-448-1614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBERG",
        "first_name": "MADELINE",
        "middle_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-26",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH20603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abdallah Obaidat, MD
• Matthew J Obal, PA-C
• Osama Ghanim Mohammad Obeidat, M.D.
• Cynthia Rodriguez Oberdan, LCSW
• Blake Elizabeth Oberfeld, MD
• Alyssa Obermiller, DO
• Wayne W. Oberti, MD
• Faith Obimdike, MD
• Diana C Obradovic, PA-C
• Mathew Obrien, MSW

• Mental Health Counselor in Gainesville, FL
• Providers in Gainesville, 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 Aug 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.