| Bluewater Behavioral Health Inc | |
|
4400 E Highway 20 Ste 208 Niceville FL 32578-9735 | |
| (575) 520-1230 | |
| (773) 492-8765 |
| Full Name | Bluewater Behavioral Health Inc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 4400 E Highway 20 Ste 208, Niceville, Florida |
| Authorized Official Name and Position | Leigh Gayle Powers (OWNER/PROVIDER) |
| Authorized Official Contact | 8507972598 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bluewater Behavioral Health Inc 4400 E Highway 20 Ste 208 Niceville FL 32578-9735 Ph: (850) 797-2598 | Bluewater Behavioral Health Inc 4400 E Highway 20 Ste 208 Niceville FL 32578-9735 Ph: (575) 520-1230 |
| NPI Number | 1922562628 |
|---|---|
| Provider Enumeration Date | 01/27/2019 |
| Last Update Date | 06/05/2026 |
| Certification Date | 06/05/2026 |
| Medicare PECOS PAC ID | 3274873435 |
|---|---|
| Medicare Enrollment ID | O20190326000623 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922562628 | NPI | - | NPPES |
| Provider Name | Leigh Gayle Powers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831280403 PECOS PAC ID: 4789637281 Enrollment ID: I20140819002412 |
| Provider Name | Grace M Francis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023560471 PECOS PAC ID: 2264715788 Enrollment ID: I20170208000381 |
| Provider Name | Kimberly Ret |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871030841 PECOS PAC ID: 4284911264 Enrollment ID: I20170428001301 |
| Provider Name | Brian W Pullam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770121535 PECOS PAC ID: 3678900891 Enrollment ID: I20200228001661 |
| Provider Name | Enri Fort |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1497385520 PECOS PAC ID: 3274900782 Enrollment ID: I20221111001354 |
| Provider Name | Kristen Nicole Peterman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962194167 PECOS PAC ID: 6103286521 Enrollment ID: I20230718000301 |
| Provider Name | Tara Nicole Kidd |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285341826 PECOS PAC ID: 8426410812 Enrollment ID: I20230817000128 |
| Provider Name | Season Manuel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801580931 PECOS PAC ID: 7416319736 Enrollment ID: I20231009001165 |
| Provider Name | Kelly A Kugler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043653421 PECOS PAC ID: 0345788725 Enrollment ID: I20240815004791 |
| Provider Name | Karen Reed |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942441894 PECOS PAC ID: 8820148018 Enrollment ID: I20241017001405 |
| Provider Name | Mariah Boyer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811625684 PECOS PAC ID: 6901315647 Enrollment ID: I20250603003614 |
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