| Lemon Bay Mental Wellness Center | |
|
1460 S Mccall Rd Englewood FL 34223-4864 | |
| (941) 681-0616 | |
| (941) 894-0415 |
| Full Name | Lemon Bay Mental Wellness Center |
|---|---|
| Speciality | Counselor |
| Location | 1460 S Mccall Rd, Englewood, Florida |
| Authorized Official Name and Position | Jerry Ervin Kuhn (OWNER) |
| Authorized Official Contact | 9416810616 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lemon Bay Mental Wellness Center 1460 S Mccall Rd Englewood FL 34223-4864 Ph: (941) 681-0616 | Lemon Bay Mental Wellness Center 1460 S Mccall Rd Englewood FL 34223-4864 Ph: (941) 681-0616 |
| NPI Number | 1679087050 |
|---|---|
| Provider Enumeration Date | 11/21/2017 |
| Last Update Date | 12/11/2023 |
| Certification Date | 12/11/2023 |
| Medicare PECOS PAC ID | 0941658918 |
|---|---|
| Medicare Enrollment ID | O20231130004040 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679087050 | NPI | - | NPPES |
| 020624800 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MH14916 (Florida) | Primary |
| Provider Name | Jerry E Kuhn |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912334251 PECOS PAC ID: 1850749821 Enrollment ID: I20231211003204 |
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