Provider Demographics
NPI:1467577916
Name:BOCCABELLA, CHRISTY M (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTY
Middle Name:M
Last Name:BOCCABELLA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MISS
Other - First Name:CHRISTY
Other - Middle Name:M
Other - Last Name:BOCCABELLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:7135 COLUMBIA CIR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-2235
Mailing Address - Country:US
Mailing Address - Phone:727-798-4564
Mailing Address - Fax:727-584-4937
Practice Address - Street 1:1301 SEMINOLE BLVD
Practice Address - Street 2:B-112
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33770-8124
Practice Address - Country:US
Practice Address - Phone:727-518-7294
Practice Address - Fax:727-584-4937
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH5438101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL59-1851170OtherGROUP PRACTICE NO