| Lsw Psychological Services, Pllc | |
|
8359 Beacon Blvd Ste 503 Fort Myers FL 33907-3066 | |
| (239) 599-5656 | |
| (239) 599-5655 |
| Full Name | Lsw Psychological Services, Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 8359 Beacon Blvd Ste 503, Fort Myers, Florida |
| Authorized Official Name and Position | Leighann Wong (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 2395995656 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lsw Psychological Services, Pllc 8359 Beacon Blvd Ste 503 Fort Myers FL 33907-3066 Ph: (239) 599-5656 | Lsw Psychological Services, Pllc 8359 Beacon Blvd Ste 503 Fort Myers FL 33907-3066 Ph: (239) 599-5656 |
| NPI Number | 1578926978 |
|---|---|
| Provider Enumeration Date | 04/01/2016 |
| Last Update Date | 12/11/2020 |
| Certification Date | 12/11/2020 |
| Medicare PECOS PAC ID | 6305194531 |
|---|---|
| Medicare Enrollment ID | O20180806000241 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578926978 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY8727 (Florida) | Primary |
| Provider Name | Leighann S Wong |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1326485707 PECOS PAC ID: 3375891500 Enrollment ID: I20180806000453 |
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