| The Therapy Room Mind Health And Wellness Llc | |
|
2581 Huntcliff Ln Panama City FL 32405-4902 | |
| (850) 520-3321 | |
| (850) 848-6490 |
| Full Name | The Therapy Room Mind Health And Wellness Llc |
|---|---|
| Speciality | Counselor |
| Location | 2581 Huntcliff Ln, Panama City, Florida |
| Authorized Official Name and Position | Katie Bergman (OWNER) |
| Authorized Official Contact | 3523626141 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Therapy Room Mind Health And Wellness Llc 2581 Huntcliff Ln Panama City FL 32405-4902 Ph: (850) 520-3321 | The Therapy Room Mind Health And Wellness Llc 2581 Huntcliff Ln Panama City FL 32405-4902 Ph: (850) 520-3321 |
| NPI Number | 1073120432 |
|---|---|
| Provider Enumeration Date | 09/29/2020 |
| Last Update Date | 03/22/2024 |
| Certification Date | 03/22/2024 |
| Medicare PECOS PAC ID | 8527418037 |
|---|---|
| Medicare Enrollment ID | O20231226001228 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073120432 | NPI | - | NPPES |
| 110722500 | Medicaid | FL |
| Provider Name | Erin Bruner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043752298 PECOS PAC ID: 7416305461 Enrollment ID: I20231130003406 |
| Provider Name | Megan Dasbach |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316558729 PECOS PAC ID: 9638529498 Enrollment ID: I20231220002484 |
| Provider Name | Katie C Bergman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1245635788 PECOS PAC ID: 9436509940 Enrollment ID: I20231226001744 |
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