Deltona Wellness & Psychiatry Clinic PLLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

DELTONA WELLNESS & PSYCHIATRY CLINIC PLLC

Practice address

2401 E Graves Ave Ste 19
Orange City, FL 32763-8582

Phone

(866) 866-7215

NPI assigned

Dec 5, 2024

Last updated

Dec 5, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Vanessa BalousNPI 1194572396

Title

President

Phone

(866) 866-7215

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Vanessa Ivette Balous, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Orange City, FL
  • NPI 1194572396
  Authorized official Same address or phone

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

{
    "created_epoch": "1733356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733356800000",
    "number": "1396551347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1618 AMBOY DR",
            "city": "DELTONA",
            "state": "FL",
            "postal_code": "327385202",
            "telephone_number": "866-866-7215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 E GRAVES AVE STE 19",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638582",
            "telephone_number": "866-866-7215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELTONA WELLNESS & PSYCHIATRY CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-05",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A",
        "authorized_official_last_name": "BALOUS",
        "authorized_official_first_name": "VANESSA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "866-866-7215"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany L Dellechiaie, APRN
• Delmar Glen Pack PA
• Deltona Medical Arts Pharmacy Inc (Town Center Pharmacy)
• Deltona Medical Center LLC
• Deltona Medical Center LLC
• David Demetree, PA-C
• Denis J Gulliver Dcpa
• Denoff Orthopaedics, P.a.
• Laith Derbas, MD
• Elizabeth Michelle Derminer, CNM/WHNP

• Nurse Practitioner in Orange City, FL
• Providers in Orange City, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.