| Suncoast Center, Inc. | |
|
4024 Central Ave St Petersburg FL 33711-1239 | |
| (727) 327-7656 | |
| (727) 322-2130 |
| Full Name | Suncoast Center, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 4024 Central Ave, St Petersburg, Florida |
| Authorized Official Name and Position | Barbara E. Daire (PRESIDENT/CEO) |
| Authorized Official Contact | 7273277656 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Suncoast Center, Inc. Po Box 10970 St Petersburg FL 33733-0970 Ph: (727) 327-7656 | Suncoast Center, Inc. 4024 Central Ave St Petersburg FL 33711-1239 Ph: (727) 327-7656 |
| NPI Number | 1659371763 |
|---|---|
| Provider Enumeration Date | 07/29/2005 |
| Last Update Date | 11/20/2020 |
| Certification Date | 11/20/2020 |
| Medicare PECOS PAC ID | 4082603295 |
|---|---|
| Medicare Enrollment ID | O20040511001229 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659371763 | NPI | - | NPPES |
| 060381300 | Medicaid | FL | |
| 060381306 | Medicaid | FL | |
| 060381301 | Medicaid | FL | |
| 060381302 | Medicaid | FL | |
| 060381309 | Medicaid | FL | |
| 003203801 | Medicaid | FL | |
| 003203800 | Medicaid | FL | |
| 060381317 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Diana Lea Oneil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982861720 PECOS PAC ID: 3173690856 Enrollment ID: I20080922000530 |
| Provider Name | Felix C Nwokolo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053504589 PECOS PAC ID: 9830276591 Enrollment ID: I20090427000219 |
| Provider Name | Aaron Brooks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760459861 PECOS PAC ID: 7416080452 Enrollment ID: I20100728000640 |
| Provider Name | Mary E Hopkins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316066657 PECOS PAC ID: 0749359941 Enrollment ID: I20110607000473 |
| Provider Name | Shari A Iovino |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437441995 PECOS PAC ID: 0345427662 Enrollment ID: I20110613000820 |
| Provider Name | Lisa M Signorelli |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902055379 PECOS PAC ID: 8022296342 Enrollment ID: I20110708000461 |
| Provider Name | Linda Ann Lefler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659414340 PECOS PAC ID: 8426071820 Enrollment ID: I20111221000625 |
| Provider Name | Emily D Reynolds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578827416 PECOS PAC ID: 9537318761 Enrollment ID: I20121004000081 |
| Provider Name | Tasha Wilkerson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245587484 PECOS PAC ID: 3375796055 Enrollment ID: I20130104000509 |
| Provider Name | Bruce C Wesolowski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427470756 PECOS PAC ID: 9931339702 Enrollment ID: I20140224001762 |
| Provider Name | Marco A Rabines |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780833038 PECOS PAC ID: 5597912055 Enrollment ID: I20140828001414 |
| Provider Name | David Newby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043591555 PECOS PAC ID: 9234438193 Enrollment ID: I20160427000401 |
| Provider Name | Anton Dragonetti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972091221 PECOS PAC ID: 8224393640 Enrollment ID: I20180605001986 |
| Provider Name | Celeste R Meier |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689034613 PECOS PAC ID: 8820349970 Enrollment ID: I20180928001038 |
| Provider Name | Roberto J Font |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780720771 PECOS PAC ID: 2466799648 Enrollment ID: I20190125001031 |
| Provider Name | Chiara D Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558827014 PECOS PAC ID: 4789924051 Enrollment ID: I20190322002185 |
| Provider Name | Maria A Boggs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467686881 PECOS PAC ID: 6204268477 Enrollment ID: I20191111000860 |
| Provider Name | Jamie E Alper |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598172496 PECOS PAC ID: 2769764018 Enrollment ID: I20200601000657 |
| Provider Name | Glenn Parkinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568051753 PECOS PAC ID: 7618382961 Enrollment ID: I20210218000600 |
| Provider Name | Jamie Hoagland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538750542 PECOS PAC ID: 2567878218 Enrollment ID: I20210304001603 |
| Provider Name | Kent W Roberts |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184140220 PECOS PAC ID: 3476961681 Enrollment ID: I20210427002622 |
| Provider Name | Yasmina Pandharpurwala |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548893423 PECOS PAC ID: 4981005337 Enrollment ID: I20210623002468 |
| Provider Name | Twana L Snow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184818817 PECOS PAC ID: 9537188651 Enrollment ID: I20210706001826 |
| Provider Name | Robert Paul Casna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063128106 PECOS PAC ID: 6305210733 Enrollment ID: I20230324002299 |
| Provider Name | Bethany Beaudet |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518653740 PECOS PAC ID: 4688034515 Enrollment ID: I20230724002253 |
| Provider Name | Erin St John |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033820501 PECOS PAC ID: 0840653358 Enrollment ID: I20230831001716 |
| Provider Name | Lynn M Chaney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346763083 PECOS PAC ID: 0446605612 Enrollment ID: I20231006002824 |
| Provider Name | Emily G Martin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487205340 PECOS PAC ID: 3577912310 Enrollment ID: I20231206000002 |
| Provider Name | Anneta M Carter |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1881915064 PECOS PAC ID: 7113376401 Enrollment ID: I20231212002350 |
| Provider Name | Ashley R Shorter |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609136555 PECOS PAC ID: 9234588526 Enrollment ID: I20231212002670 |
| Provider Name | Jessica N Futoran |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1578967790 PECOS PAC ID: 8022467323 Enrollment ID: I20231212002804 |
| Provider Name | Suzan L Miller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598186033 PECOS PAC ID: 6901255207 Enrollment ID: I20231212002927 |
| Provider Name | Erin Conte |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770053605 PECOS PAC ID: 4688023831 Enrollment ID: I20231213000886 |
| Provider Name | Ramon Maisonet |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336355684 PECOS PAC ID: 2668821810 Enrollment ID: I20231213000991 |
| Provider Name | Elizabeth Hinckley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265112841 PECOS PAC ID: 7719336973 Enrollment ID: I20231213001193 |
| Provider Name | Jillian T Kinney |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1588131726 PECOS PAC ID: 0345699500 Enrollment ID: I20231213001255 |
| Provider Name | Brittany Lennartsson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1649783002 PECOS PAC ID: 9133578396 Enrollment ID: I20231213001349 |
| Provider Name | Kristin A Mathre |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1295744217 PECOS PAC ID: 5991007486 Enrollment ID: I20231213002794 |
| Provider Name | Stephanie Ganoe |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518570381 PECOS PAC ID: 9032568191 Enrollment ID: I20231214001434 |
| Provider Name | Ronald L Bell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831547793 PECOS PAC ID: 7517316698 Enrollment ID: I20231214002281 |
| Provider Name | Karla L Weiskopf |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265712327 PECOS PAC ID: 8820447915 Enrollment ID: I20231214002565 |
| Provider Name | Andrea R Brockman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295275097 PECOS PAC ID: 5799134896 Enrollment ID: I20231214002761 |
| Provider Name | Samantha M Maederer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790213585 PECOS PAC ID: 9739538786 Enrollment ID: I20231215001136 |
| Provider Name | Elizabeth J Menchen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386947596 PECOS PAC ID: 1254781784 Enrollment ID: I20231227000233 |
| Provider Name | Kaymeron Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598431462 PECOS PAC ID: 6608226089 Enrollment ID: I20231227002264 |
| Provider Name | Juliana P Menke |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1215218581 PECOS PAC ID: 1153771571 Enrollment ID: I20231228000149 |
| Provider Name | Naisha Reid |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710457312 PECOS PAC ID: 6204202021 Enrollment ID: I20231229000897 |
| Provider Name | Monica Arreaga |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679263057 PECOS PAC ID: 4082058565 Enrollment ID: I20240223001356 |
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