Katie C Bergman, LMHC, MC | |
2581 Huntcliff Ln, Panama City, FL 32405-4902 | |
(850) 520-3321 | |
(850) 848-6490 |
Full Name | Katie C Bergman |
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Gender | Female |
Speciality | Counselor - Mental Health |
Location | 2581 Huntcliff Ln, Panama City, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1245635788 | NPI | - | NPPES |
110724100 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | PPC-863 (Wyoming) | Secondary |
101YM0800X | Counselor - Mental Health | MH17204 (Florida) | Primary |
Entity Name | Grow Mental Health Services, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1073120432 PECOS PAC ID: 8527418037 Enrollment ID: O20231226001228 |
Mailing Address | Practice Location Address |
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Katie C Bergman, LMHC, MC 2581 Huntcliff Ln, Panama City, FL 32405-4902 Ph: (850) 520-3321 | Katie C Bergman, LMHC, MC 2581 Huntcliff Ln, Panama City, FL 32405-4902 Ph: (850) 520-3321 |
Angela Gruber, Counselor Medicare: Not Enrolled in Medicare Practice Location: 525 E 15th St, Panama City, FL 32405 Phone: 850-522-4485 Fax: 850-522-4484 | |
Cheryl Powell, Counselor Medicare: Not Enrolled in Medicare Practice Location: 525 E 15th St, Panama City, FL 32405 Phone: 850-522-4485 Fax: 850-522-4484 | |
Anita Losoya-evon, M.S. Counselor Medicare: Not Enrolled in Medicare Practice Location: 2711 W 15th St, Panama City, FL 32401 Phone: 850-769-6001 | |
Sakeena Powe, M.S Counselor Medicare: Not Enrolled in Medicare Practice Location: 2711 W 15th St, Panama City, FL 32401 Phone: 850-769-6001 | |
Samantha Ashley Morrison, MS Counselor Medicare: Not Enrolled in Medicare Practice Location: 2711 W 15th St, Panama City, FL 32401 Phone: 850-769-6001 | |
Ms. Jeanie J. Wolter, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 648 Florida Ave, Panama City, FL 32401 Phone: 850-769-6001 Fax: 850-769-6003 | |
Kelly Bennett, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2711 W 15th St, Panama City, FL 32401 Phone: 850-769-6001 |