Clearwater, Iva Maylene Hallsted

Clearwater, Iva Maylene Hallsted is an individual health care provider with primary practice located at 4500 W Midway Rd New Horizons Of The Treasure Coast Inc, Ft Pierce FL 34981. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Clearwater, Iva Maylene Hallsted can be contacted via phone (772) 672-5600.

Contact Information

Primary practice address
4500 W Midway Rd New Horizons Of The Treasure Coast Inc Ft Pierce FL 34981
Phone: (772) 672-5600
Fax: (772) 468-4033
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 1803 Florida
Behavioral Health & Social Service Providers / Clinical 1041C0700X SW4959 Florida

Profile Details

NPI number 1952419749
LBN Legal business name Clearwater, Iva Maylene Hallsted
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 29th, 2006
Last updated Sep 25th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952419749 NPPES
Florida Other 2027492 CIGNA
Florida Other 238116 CIGNA
Florida Other 28762 CIGNA
Florida MEDICAID 763665200 CIGNA

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