Provider Demographics
NPI:1457825366
Name:PASCALLI, JACQUELYN (CMHC)
Entity Type:Individual
Prefix:
First Name:JACQUELYN
Middle Name:
Last Name:PASCALLI
Suffix:
Gender:F
Credentials:CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8480 SE APPLE LANE
Mailing Address - Street 2:
Mailing Address - City:HOBE SOUND
Mailing Address - State:FL
Mailing Address - Zip Code:33455-7445
Mailing Address - Country:US
Mailing Address - Phone:561-723-2513
Mailing Address - Fax:
Practice Address - Street 1:3577 SW CORPORATE PKWY
Practice Address - Street 2:
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990-8153
Practice Address - Country:US
Practice Address - Phone:772-220-3439
Practice Address - Fax:772-220-3484
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-14
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty