Active NPI
Nicolette Immediato
- Mental Health Counselor
- Ocala, FL
National Provider Identifier
1861922296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MH15408
- Practice address
- 2609 SW 33Rd St Ste 101
Ocala, FL 34471-7775 - Phone
- (352) 519-6991
- Fax
- (352) 519-6991
- NPI assigned
- Jun 18, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MH15408 | FL | Primary |
Addresses
Primary practice location
2609 SW 33Rd St Ste 101
Ocala, FL 34471-7775
Mailing address
19423 SW 77TH Loop
Dunnellon, FL 34432-9516
Phone (352) 519-6991
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 4, 2025 through Feb 4, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MH15408 | FL | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Haven Counseling and Wellness | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Adult Mental Health Clinic/Center
- Ocala, FL
- NPI 1053823930
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1506297600000",
"number": "1861922296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19423 SW 77TH LOOP",
"city": "DUNNELLON",
"state": "FL",
"postal_code": "344329516",
"telephone_number": "352-519-6991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2609 SW 33RD ST STE 101",
"city": "OCALA",
"state": "FL",
"postal_code": "344717775",
"telephone_number": "352-519-6991",
"fax_number": "352-519-6991"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IMMEDIATO",
"first_name": "NICOLETTE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-18",
"last_updated": "2017-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH15408",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ocala, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.