Provider Demographics
NPI:1942436787
Name:SCOVILLE, DANA MELISSA (LMHC)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:MELISSA
Last Name:SCOVILLE
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 1:12300 ALTERNATE A1A
Mailing Address - Street 2:SUITE 113
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-2205
Mailing Address - Country:US
Mailing Address - Phone:561-339-7665
Mailing Address - Fax:561-627-1524
Practice Address - Street 1:12300 ALTERNATE A1A
Practice Address - Street 2:SUITE 113
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-2205
Practice Address - Country:US
Practice Address - Phone:561-339-7665
Practice Address - Fax:561-627-1524
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-08
Last Update Date:2009-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH9322101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health