| Pamela J Corkum, LICSW | |
|
12196 County Road 512, Fellsmere, FL 32948-5463 | |
| (772) 257-8224 | |
| (772) 252-3245 |
| Full Name | Pamela J Corkum |
|---|---|
| Gender | Female |
| Speciality | Counselor - Mental Health |
| Location | 12196 County Road 512, Fellsmere, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134604952 | NPI | - | NPPES |
| SW21751 | Other | FL | LCSW |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | SW21751 (Florida) | Primary |
| Entity Name | Treasure Coast Community Health Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1891740916 PECOS PAC ID: 4082625827 Enrollment ID: O20130401000508 |
| Entity Name | Grow Healthcare Group Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20210414000053 |
| Mailing Address | Practice Location Address |
|---|---|
| Pamela J Corkum, LICSW 1555 Indian River Blvd Ste B210, Vero Beach, FL 32960-7113 Ph: (772) 257-8224 | Pamela J Corkum, LICSW 12196 County Road 512, Fellsmere, FL 32948-5463 Ph: (772) 257-8224 |
Michael P Ferrentino, ED.D., L.M.H.C. Counselor Medicare: Medicare Enrolled Practice Location: 12196 County Road 512, Fellsmere, FL 32948 Phone: 772-257-8224 Fax: 772-252-3245 | |
Leslie Sikaffy, LCSW Counselor Medicare: Accepting Medicare Assignments Practice Location: 12196 County Road 512, Fellsmere, FL 32948 Phone: 772-257-8224 |