| Back Door Counseling | |
|
1639 Cape Coral Pkwy E Suite 211 Cape Coral FL 33904-9651 | |
| (239) 699-8622 | |
| Not Available |
| Full Name | Back Door Counseling |
|---|---|
| Speciality | Counselor |
| Location | 1639 Cape Coral Pkwy E, Cape Coral, Florida |
| Authorized Official Name and Position | Tara P Hruby (LICENSED MENTAL HEALTH COUNSELOR) |
| Authorized Official Contact | 2396998622 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Back Door Counseling 1101 Ne 15th St Cape Coral FL 33909-1414 Ph: (239) 699-8622 | Back Door Counseling 1639 Cape Coral Pkwy E Suite 211 Cape Coral FL 33904-9651 Ph: (239) 699-8622 |
| NPI Number | 1043654791 |
|---|---|
| Provider Enumeration Date | 04/24/2013 |
| Last Update Date | 04/24/2013 |
| Medicare PECOS PAC ID | 5698110286 |
|---|---|
| Medicare Enrollment ID | O20240305003856 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043654791 | NPI | - | NPPES |
| 271633359 | Other | FL | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MH8266 (Florida) | Primary |
| Provider Name | Tara Hruby |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922262138 PECOS PAC ID: 2769827351 Enrollment ID: I20240305003945 |
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