Provider Demographics
NPI:1457702755
Name:CASCIO, ERIKA MICHELE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ERIKA
Middle Name:MICHELE
Last Name:CASCIO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:ERIKA
Other - Middle Name:MICHELE
Other - Last Name:MELLOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:5703 SW 10TH PL
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-3864
Mailing Address - Country:US
Mailing Address - Phone:330-819-8662
Mailing Address - Fax:
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:SUITE G901
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3003
Practice Address - Country:US
Practice Address - Phone:352-273-5117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-28
Last Update Date:2017-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY9488103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL019066700Medicaid
FL019066700Medicaid