Individual provider Active NPI

Gabriela M Mancini, PSY.D.

  • Clinical Psychologist
  • Wellington, FL
National Provider Identifier
1558649889
Registry record updated Jul 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY 8317 Issued in FL
Practice address
125 S State Road 7
# 104-449
Wellington, FL 33414-4385
Phone
(561) 203-5867
NPI assigned
Aug 3, 2011
Last updated
Jul 2, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY 8317 FL Primary

Addresses

Primary practice location

125 S State Road 7
# 104-449
Wellington, FL 33414-4385

Mailing address

125 S State Road 7
# 104-449
Wellington, FL 33414-4385
Phone (954) 553-8182

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190828001096 FL Practitioner - Clinical Psychologist 3072841170 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Blue Moon Senior CounselingGroup PAC ID 6103099759, 26 clinicians

Practice addresses (Care Compare)

900 NE 18TH Ave
Suite 1207
Fort Lauderdale, FL 33304-3052
Phone (954) 489-2728

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY 8317FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Moon Senior Counseling CurrentSince Apr 17, 2025 Accepting new patients
Dr. Dana Ratsprecher Psy.D., LLC Clinical CurrentSince Sep 20, 2022 Accepting new patients
Agape Mental Health Past Accepting new patients

Locations

10204 Bode St
Ste B
Plainfield, IL 60585
Phone (630) 229-6462

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1312329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562025600000",
    "number": "1558649889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 S STATE ROAD 7",
            "address_2": "# 104-449",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334144385",
            "telephone_number": "954-553-8182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 S STATE ROAD 7",
            "address_2": "# 104-449",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334144385",
            "telephone_number": "561-203-5867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCINI",
        "first_name": "GABRIELA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-03",
        "last_updated": "2019-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY 8317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

Verify at the official NPI Registry.