SACRED MIND PSYCHIATRY LLC NPI 1003794678

NPI Information

  • NPI: 1003794678
  • Provider Name: SACRED MIND PSYCHIATRY LLC
  • Classification: Clinic/Center - 261QM0850X
  • Specialization: Adult Mental Health
  • Entity Type: Organization
  • Address: 4255 SW CAMBRIDGE GLN
    LAKE CITY, FL
    ZIP 32024
  • Phone: (386) 623-1198

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NPI Details

SACRED MIND PSYCHIATRY LLC is an adult mental health clinic center in Lake City, FL. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. SACRED MIND PSYCHIATRY LLC NPI is 1003794678. The provider is registered as an organization entity type.

The provider's business location address is:

4255 SW CAMBRIDGE GLN
LAKE CITY, FL
ZIP 32024-431
Phone: (386) 623-1198

The provider's authorized official is Michlalona Scippio .
The authorized official title is Arnp and has the following contact phone number (386) 623-1198.

The enumeration date for this NPI number is 8/22/2025 and was last updated on 8/24/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0850XClinic/CenterAdult Mental HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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