Provider Demographics
NPI:1851683619
Name:SCAVELLI, MONIQUE (LMHC)
Entity Type:Individual
Prefix:
First Name:MONIQUE
Middle Name:
Last Name:SCAVELLI
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 1:3560 CARDINAL POINT DR
Mailing Address - Street 2:SUITE 204
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32257-9235
Mailing Address - Country:US
Mailing Address - Phone:904-737-7242
Mailing Address - Fax:
Practice Address - Street 1:3560 CARDINAL POINT DR
Practice Address - Street 2:SUITE 204
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257-9235
Practice Address - Country:US
Practice Address - Phone:904-737-7242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-11
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH6667101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health