| Latorre Counseling Center Co | |
|
11512 Lake Mead Ave Unit 405 Jacksonville FL 32256-9687 | |
| (904) 479-5863 | |
| Not Available |
| Full Name | Latorre Counseling Center Co |
|---|---|
| Speciality | Counselor |
| Location | 11512 Lake Mead Ave Unit 405, Jacksonville, Florida |
| Authorized Official Name and Position | Gabrielle Latorre (OWNER) |
| Authorized Official Contact | 9044795863 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Latorre Counseling Center Co 11512 Lake Mead Ave Unit 405 Jacksonville FL 32256-9687 Ph: (904) 479-5863 | Latorre Counseling Center Co 11512 Lake Mead Ave Unit 405 Jacksonville FL 32256-9687 Ph: (904) 479-5863 |
| NPI Number | 1508638974 |
|---|---|
| Provider Enumeration Date | 10/27/2023 |
| Last Update Date | 10/30/2023 |
| Certification Date | 10/30/2023 |
| Medicare PECOS PAC ID | 2668823782 |
|---|---|
| Medicare Enrollment ID | O20240112001591 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508638974 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Gabrielle C Latorre |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861092819 PECOS PAC ID: 3577914696 Enrollment ID: I20240112001799 |
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