SACRED MIND PSYCHIATRY LLC
NPI 1003794678
Clinic/Center - Adult Mental Health in Lake City, FL
About Sacred Mind Psychiatry Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SACRED MIND PSYCHIATRY LLC (NPI 1003794678) is a healthcare organization registered as an adult mental health in Lake City, Florida and active in the NPI registry since August 2025. The organization lists Michlalona Scippio, Arnp, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Sacred Mind Psychiatry Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Sacred Mind Psychiatry LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Sacred Mind Psychiatry LLC's NPI number?
The NPI number for Sacred Mind Psychiatry LLC is 1003794678. It was assigned to this organization in the NPPES registry on August 22, 2025.
Where is Sacred Mind Psychiatry LLC located?
Sacred Mind Psychiatry LLC is located at 4255 SW Cambridge Gln, Lake City, FL 32024. The listed phone number is (386) 623-1198.
What is Sacred Mind Psychiatry LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Adult Mental Health, with taxonomy code 261QM0850X.
Is Sacred Mind Psychiatry LLC enrolled in Medicare?
Yes. Sacred Mind Psychiatry LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Sacred Mind Psychiatry LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Sacred Mind Psychiatry LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Sacred Mind Psychiatry LLC was last updated on August 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Sacred Mind Psychiatry Llc · NPI 1003794678
Adult Mental Health organization in Lake City, Florida. Organization record, active in the CMS NPPES registry since August 22, 2025.
## Identity
- **NPI:** 1003794678 (Entity type: Organization)
- **Enumerated:** August 22, 2025
- **Primary specialty:** Clinic/Center - Adult Mental Health · taxonomy 261QM0850X
- **Organization subpart:** No
- **Authorized official:** Michlalona Scippio, ARNP
## Practice location
- **Address:** 4255 SW CAMBRIDGE GLN, Lake City, FL 32024-3431
- **Phone:** (386) 623-1198
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 24, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1003794678) · Data from the CMS NPPES public registry.