Kerry M Sise, M.S.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

IMH 5801 Issued in FL

Practice address

1404 Rancho Villa Dr
Gulf Breeze, FL 32563-2618

Phone

(850) 485-4773

NPI assigned

Dec 4, 2007

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

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197417600000",
    "number": "1962684779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1404 RANCHO VILLA DR",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325632618",
            "telephone_number": "850-485-4773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 RANCHO VILLA DR",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325632618",
            "telephone_number": "850-485-4773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISE",
        "first_name": "KERRY",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-04",
        "last_updated": "2007-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH 5801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Lee Sigler, ARNP
• Horace Lindsay Simpson, M.D.
• Sims Pharmacy LLC
• Sims Pharmacy LLC
• Sharon J Sims, RPH
• Brett R Smith, MD
• Brian Smith
• Ja'Slynn Smith, RBT
• Kasey Smith
• Michael J Smith, MD

• Mental Health Counselor in Gulf Breeze, FL
• Providers in Gulf Breeze, 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 Dec 12, 2007; 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.