| Mr Fred Sacklow, LCSW | |
|
6950 Philips Hwy Ste 11, Jacksonville, FL 32216 | |
| (904) 239-3677 | |
| (904) 866-4029 |
| Full Name | Mr Fred Sacklow |
|---|---|
| Gender | Male |
| Speciality | Clinical Social Worker |
| Experience | 45 Years |
| Location | 6950 Philips Hwy Ste 11, Jacksonville, Florida |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619968716 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | R02529-1 (New York) | Secondary |
| 1041C0700X | Social Worker - Clinical | SW14596 (Florida) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Gauler And Associates, Pllc | 6901046945 | 5 |
| Entity Name | Gauler & Associates, Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1730405002 PECOS PAC ID: 6901046945 Enrollment ID: O20130715000753 |
| Entity Name | Refresh Canopy Cove, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1730661752 PECOS PAC ID: 3779822119 Enrollment ID: O20190304000354 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Fred Sacklow, LCSW 6950 Philips Hwy Ste 11, Jacksonville, FL 32216-6082 Ph: (904) 239-3677 | Mr Fred Sacklow, LCSW 6950 Philips Hwy Ste 11, Jacksonville, FL 32216 Ph: (904) 239-3677 |
Mrs. Amanda Kay Callahan, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 5776 Saint Augustine Rd, Jacksonville, FL 32207 Phone: 904-448-4700 | |
Carol Lynne Miller, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 11812 Valley Garden Dr, Jacksonville, FL 32225 Phone: 904-673-8237 | |
Ms. Latisha M Hill, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 4720 Salisbury Rd, Jacksonville, FL 32256 Phone: 904-493-6190 | |
Susan Lee, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 12086 Ft.caroline Rd Suite 401, Jacksonville, FL 32225 Phone: 904-565-1271 Fax: 904-645-7325 | |
Sarah Johanna Miller, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 820 Prudential Dr Ste 510, Jacksonville, FL 32207 Phone: 904-376-3800 | |
Kallyn Richardson, Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 11478 Harlan Dr, Jacksonville, FL 32218 Phone: 734-834-0459 | |
Maria Susan Martinez, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1760 Edgewood Ave W, Jacksonville, FL 32208 Phone: 904-301-4900 Fax: 904-924-1773 |