Individual provider Active NPI

Katie A. Cavallaro, M.A.

  • Mental Health Counselor
  • Pinellas Park, FL
National Provider Identifier
1215254131
Registry record updated May 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
IMH7498 Issued in FL
Practice address
3491 Gandy Blvd N
Pinellas Park, FL 33781-2658
Phone
(727) 547-0607
Fax
(727) 547-6752
NPI assigned
May 2, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X IMH7498 FL Primary

Addresses

Primary practice location

3491 Gandy Blvd N
Pinellas Park, FL 33781-2658

Mailing address

3491 Gandy Blvd N
Pinellas Park, FL 33781-2658
Phone (727) 547-0607

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
IMH7498FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1272758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272758400000",
    "number": "1215254131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3491 GANDY BLVD N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337812658",
            "telephone_number": "727-547-0607",
            "fax_number": "727-547-6752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3491 GANDY BLVD N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337812658",
            "telephone_number": "727-547-0607",
            "fax_number": "727-547-6752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVALLARO",
        "first_name": "KATIE",
        "middle_name": "A.",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-02",
        "last_updated": "2010-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH7498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinellas Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2010; 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.