Provider Demographics
NPI:1255131421
Name:SEMORILE, IDA GISELLA
Entity type:Individual
Prefix:
First Name:IDA
Middle Name:GISELLA
Last Name:SEMORILE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 ALPINE DR SE
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20175-6126
Mailing Address - Country:US
Mailing Address - Phone:773-209-9807
Mailing Address - Fax:
Practice Address - Street 1:111 ALPINE DR SE
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175-6126
Practice Address - Country:US
Practice Address - Phone:773-209-9807
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health