Provider Demographics
NPI:1134638596
Name:MESMER, PATRICIA ANN (MS ,CAP, CMHP, ICADC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:MESMER
Suffix:
Gender:F
Credentials:MS ,CAP, CMHP, ICADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5663 SE MITZI LN
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-8002
Mailing Address - Country:US
Mailing Address - Phone:561-301-3550
Mailing Address - Fax:
Practice Address - Street 1:400 CIVIC CENTER WAY STE B
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-5000
Practice Address - Country:US
Practice Address - Phone:561-408-2495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-28
Last Update Date:2017-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3204101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5051OtherFLORIDA CERTIFICATION BOARD CMHP
FL3204OtherFLORIDA CERTIFICATION BOARD CAP