Elendea Rose Degaetano, RMFTI, RMHCI

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

IMT4296 Issued in FL

Practice address

121 W Pennsylvania Ave
Deland, FL 32720-3429

Phone

(386) 290-6525

NPI assigned

Dec 30, 2024

Last updated

Dec 30, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1735516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1336958826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 N BOSTON AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327242974",
            "telephone_number": "386-290-6525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 W PENNSYLVANIA AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327203429",
            "telephone_number": "386-290-6525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "612 W New York Ave",
            "address_purpose": "LOCATION",
            "city": "Deland",
            "state": "FL",
            "postal_code": "327205274",
            "country_code": "US",
            "telephone_number": "386-290-6525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEGAETANO",
        "first_name": "ELENDEA",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "credential": "RMFTI, RMHCI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-30",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH26998",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "IMT4296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Deland, FL
• Providers in Deland, FL by specialty
• Marriage & Family Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; 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.