| Stacey Herdegen, LMFT, NCC | |
|
408 N Summerlin Ave, Orlando, FL 32803-5338 | |
| (941) 323-7007 | |
| Not Available |
| Full Name | Stacey Herdegen |
|---|---|
| Gender | Female |
| Speciality | Marriage & Family Therapist |
| Location | 408 N Summerlin Ave, Orlando, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275275026 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | MT4854 (Florida) | Secondary |
| 106H00000X | Marriage & Family Therapist | MT4854 (Florida) | Primary |
| Entity Name | Neurogenesis Center Of Florida Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922474907 PECOS PAC ID: 9739420365 Enrollment ID: O20190912002470 |
| Mailing Address | Practice Location Address |
|---|---|
| Stacey Herdegen, LMFT, NCC 408 N Summerlin Ave, Orlando, FL 32803-5338 Ph: (941) 323-7007 | Stacey Herdegen, LMFT, NCC 408 N Summerlin Ave, Orlando, FL 32803-5338 Ph: (941) 323-7007 |
Jill Mercer Graves, MFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 7550 Futures Dr, Suite 105, Orlando, FL 32819 Phone: 407-730-7983 | |
Mrs. Elaine Marie Summers, M.S., L.M.F.T. Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 730 Courtland St, Orlando, FL 32804 Phone: 407-975-3800 Fax: 407-975-3900 | |
Dr. Kenneth Randall Lewis, EDD, LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 1802 N Alafaya Trl, Suite 115, Orlando, FL 32826 Phone: 407-766-0020 | |
Mr. David Brian Stevens, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 2101 Park Center Drive Suite 270, Associates In Psychology & Counseling, Orlando, FL 32835 Phone: 407-523-1213 Fax: 407-523-2398 | |
Mrs. Susan Clay Nuckols, LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 100 W Columbia St, 100 W. Columbia St., Orlando, FL 32806 Phone: 407-245-0014 | |
Mrs. Samantha Lyons, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 9684 Sweetleaf St, Orlando, FL 32827 Phone: 407-616-4339 | |
Mr. Irving Lionel Silver, MA Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 7353 W Sand Lake Rd, Orlando, FL 32819 Phone: 407-754-6069 |