Provider Demographics
NPI:1386617454
Name:NACCARATO, CELIA (PHD, PMHNP-BC)
Entity type:Individual
Prefix:DR
First Name:CELIA
Middle Name:
Last Name:NACCARATO
Suffix:
Gender:F
Credentials:PHD, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 COUNTY ROAD 466
Mailing Address - Street 2:SUITE 302
Mailing Address - City:LADY LAKE
Mailing Address - State:FL
Mailing Address - Zip Code:32159-4205
Mailing Address - Country:US
Mailing Address - Phone:352-633-3311
Mailing Address - Fax:352-204-9651
Practice Address - Street 1:809 CR 466, SUITE 302
Practice Address - Street 2:
Practice Address - City:LADY LAKE
Practice Address - State:FL
Practice Address - Zip Code:32159
Practice Address - Country:US
Practice Address - Phone:352-633-3311
Practice Address - Fax:352-204-9651
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF400920-1363LP0808X, 363LP0808X
FL2611292363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health