| Branch Lane Psychotherapy | |
|
90 Fort Wade Rd Ste 100 Ponte Vedra Beach FL 32081-5114 | |
| (904) 201-9851 | |
| Not Available |
| Full Name | Branch Lane Psychotherapy |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 90 Fort Wade Rd Ste 100, Ponte Vedra Beach, Florida |
| Authorized Official Name and Position | Erica Oppenheimer (MANAGER) |
| Authorized Official Contact | 3473770973 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Branch Lane Psychotherapy 90 Fort Wade Rd Ste 100 Ponte Vedra Beach FL 32081-5114 Ph: (347) 377-0973 | Branch Lane Psychotherapy 90 Fort Wade Rd Ste 100 Ponte Vedra Beach FL 32081-5114 Ph: (904) 201-9851 |
| NPI Number | 1447125869 |
|---|---|
| Provider Enumeration Date | 10/07/2025 |
| Last Update Date | 07/07/2026 |
| Certification Date | 07/07/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447125869 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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