Jalyssa Cardell

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

IMH18798 Issued in FL

Practice address

2222 Colonial Rd
Fort Pierce, FL 34950-5309

Phone

(772) 489-4726

NPI assigned

Feb 25, 2020

Sex

Female

Sole proprietor

Yes

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.

• Suncoast Mental Health Center Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Stuart, FL
  • NPI 1689242620
  NPD

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

{
    "created_epoch": "1582588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582588800000",
    "number": "1548894991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 COLONIAL RD",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349505309",
            "telephone_number": "772-489-4726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 COLONIAL RD",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349505309",
            "telephone_number": "772-489-4726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDELL",
        "first_name": "JALYSSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-25",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH18798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Naugle Campbell, MS, LMHC
• Robert Dwight Campbell, MSW
• Naty Canales
• Kelly Cannon, APRN, FNP-BC
• Nicole D Canterella, PMHNP, BC
• Irma Cardenosa Garcia, RBT
• Vanessa Cardis
• Care One Support LLC
• Carehere LLC
• Jennifer Carey, MS, CCC, SLP

• Mental Health Counselor in Fort Pierce, FL
• Providers in Fort Pierce, 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 Feb 25, 2020; 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.