Provider Demographics
NPI:1639778574
Name:D'ALESSIO, JAIME (MA, NCC, MFT INTERN)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:
Last Name:D'ALESSIO
Suffix:
Gender:F
Credentials:MA, NCC, MFT INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 E PALMETTO PARK RD APT 953
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-5195
Mailing Address - Country:US
Mailing Address - Phone:561-841-3500
Mailing Address - Fax:
Practice Address - Street 1:413 E PALMETTO PARK RD APT 953
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-5195
Practice Address - Country:US
Practice Address - Phone:503-312-4530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-21
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR5969101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health