| Covenant Counseling Services Inc | |
|
160 Bermuda Ct Ponte Vedra FL 32082-2503 | |
| (904) 625-1101 | |
| Not Available |
| Full Name | Covenant Counseling Services Inc |
|---|---|
| Speciality | Psychologist |
| Location | 160 Bermuda Ct, Ponte Vedra, Florida |
| Authorized Official Name and Position | Richard S Oxhorn (PRESIDENT) |
| Authorized Official Contact | 9046251101 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Covenant Counseling Services Inc Po Box 934068 Margate FL 33093-4068 Ph: (954) 366-2700 | Covenant Counseling Services Inc 160 Bermuda Ct Ponte Vedra FL 32082-2503 Ph: (904) 625-1101 |
| NPI Number | 1760576888 |
|---|---|
| Provider Enumeration Date | 10/03/2006 |
| Last Update Date | 05/12/2015 |
| Medicare PECOS PAC ID | 3173629235 |
|---|---|
| Medicare Enrollment ID | O20070507000152 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760576888 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY6210 (Florida) | Primary |
| Provider Name | Richard S Oxhorn |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1114011228 PECOS PAC ID: 6507818903 Enrollment ID: I20050214000826 |
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