Provider Demographics
NPI:1235148149
Name:PRESCOTT, CARMELLA MARIA (LMHC)
Entity Type:Individual
Prefix:MS
First Name:CARMELLA
Middle Name:MARIA
Last Name:PRESCOTT
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3725 BELFORT RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-5813
Mailing Address - Country:US
Mailing Address - Phone:904-296-1055
Mailing Address - Fax:904-448-7700
Practice Address - Street 1:3725 BELFORT RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-5813
Practice Address - Country:US
Practice Address - Phone:904-296-1055
Practice Address - Fax:904-448-7700
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH5783101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health