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15690 Tokara Ct Jacksonville FL 32218-8164 | |
| (904) 629-8041 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Social Worker |
| Location | 15690 Tokara Ct, Jacksonville, Florida |
| Authorized Official Name and Position | Helan Essa (OWNER) |
| Authorized Official Contact | 9046290841 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
15690 Tokara Ct Jacksonville FL 32218-8164 Ph: (904) 629-8041 | 15690 Tokara Ct Jacksonville FL 32218-8164 Ph: (904) 629-8041 |
| NPI Number | 1659965911 |
|---|---|
| Provider Enumeration Date | 02/25/2021 |
| Last Update Date | 06/15/2021 |
| Certification Date | 06/15/2021 |
| Medicare PECOS PAC ID | 1658772959 |
|---|---|
| Medicare Enrollment ID | O20210624000153 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659965911 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Helan Essa |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922691591 PECOS PAC ID: 2567863863 Enrollment ID: I20210624000226 |
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