| Destin Counseling Center | |
|
215 Mountain Drive Suite 106 Destin FL 32541-2346 | |
| (850) 837-9100 | |
| (850) 837-3774 |
| Full Name | Destin Counseling Center |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 215 Mountain Drive, Destin, Florida |
| Authorized Official Name and Position | Lyle J Sandquist (PRESIDENT OWNER) |
| Authorized Official Contact | 8508379100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Destin Counseling Center 215 Mountain Drive Suite 106 Destin FL 32541-2346 Ph: (850) 837-9100 | Destin Counseling Center 215 Mountain Drive Suite 106 Destin FL 32541-2346 Ph: (850) 837-9100 |
| NPI Number | 1831174705 |
|---|---|
| Provider Enumeration Date | 12/13/2005 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 9032100839 |
|---|---|
| Medicare Enrollment ID | O20040520000787 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831174705 | NPI | - | NPPES |
| X0898 | Other | FL | BCBS |
| Provider Name | John W Keller |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1043248800 PECOS PAC ID: 6002867322 Enrollment ID: I20050203000728 |
| Provider Name | Victoria E Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245253558 PECOS PAC ID: 4688673536 Enrollment ID: I20061204000383 |
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