| Trisha S Peterson, RSWI | |
|
110 Sanchez Ave, Edgewater, FL 32132-1638 | |
| (386) 481-4782 | |
| Not Available |
| Full Name | Trisha S Peterson |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 110 Sanchez Ave, Edgewater, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023561883 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 14521 (Florida) | Primary |
| Entity Name | Sea Change Counseling Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1144920711 PECOS PAC ID: 5294198297 Enrollment ID: O20230823003744 |
| Mailing Address | Practice Location Address |
|---|---|
| Trisha S Peterson, RSWI 110 Sanchez Ave, Edgewater, FL 32132-1638 Ph: (386) 481-4782 | Trisha S Peterson, RSWI 110 Sanchez Ave, Edgewater, FL 32132-1638 Ph: (386) 481-4782 |
Carmen Michele Virtuoso, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 2102 S Ridgewood Ave, Edgewater, FL 32141 Phone: 386-853-9100 | |
Victoria Plechac-diaz, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 239 N Ridgewood Ave, Edgewater, FL 32132 Phone: 386-427-4868 Fax: 386-427-5157 | |
Mrs. Dorothy Irene Cast, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 307 Cherrywood Ln, Edgewater, FL 32132 Phone: 386-663-7031 | |
Audra Mary Willsey, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3504 Rock Oak Trl, Edgewater, FL 32141 Phone: 321-287-8567 |