Provider Demographics
NPI:1750775243
Name:NACCARATO, GABRIELA (LMHC, NCC)
Entity type:Individual
Prefix:
First Name:GABRIELA
Middle Name:
Last Name:NACCARATO
Suffix:
Gender:F
Credentials:LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10602 KIDBROOKE CT
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626-2546
Mailing Address - Country:US
Mailing Address - Phone:813-389-4442
Mailing Address - Fax:813-635-9725
Practice Address - Street 1:300 PINELAS STREET
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3804
Practice Address - Country:US
Practice Address - Phone:727-462-3358
Practice Address - Fax:727-462-3358
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-24
Last Update Date:2017-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH13386101YM0800X, 251S00000X
FL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1750775243Medicaid