Ellan Destinasse, BS, CBHCM

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

CBHCM101948 Issued in FL

Practice address

6750 N Andrews Ave Ste 200
Ft Lauderdale, FL 33309-2180

Phone

(954) 258-6017

NPI assigned

Jul 3, 2018

Last updated

Jul 3, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

State licenses

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

{
    "created_epoch": "1530576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1750877742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6750 N ANDREWS AVE STE 200",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333092180",
            "telephone_number": "954-258-6017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6750 N ANDREWS AVE STE 200",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333092180",
            "telephone_number": "954-258-6017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESTINASSE",
        "first_name": "ELLAN",
        "credential": "BS, CBHCM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-03",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "FL",
            "license": "CBHCM101948",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NA",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Case Manager/Care Coordinator in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Case Manager/Care Coordinator in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2018; 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.