|
| |
|
10245 Centurion Pkwy N Ste 250 Jacksonville FL 32256-0561 | |
| (904) 674-3521 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 10245 Centurion Pkwy N Ste 250, Jacksonville, Florida |
| Authorized Official Name and Position | Erin Pash (OWNER) |
| Authorized Official Contact | 9046743521 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
10245 Centurion Pkwy N Ste 250 Jacksonville FL 32256-0561 Ph: (904) 674-3521 | 10245 Centurion Pkwy N Ste 250 Jacksonville FL 32256-0561 Ph: (904) 674-3521 |
| NPI Number | 1417609645 |
|---|---|
| Provider Enumeration Date | 01/19/2022 |
| Last Update Date | 09/25/2024 |
| Certification Date | 09/25/2024 |
| Medicare PECOS PAC ID | 6901278076 |
|---|---|
| Medicare Enrollment ID | O20230218000551 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417609645 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Kathleen Marie Stevens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407860034 PECOS PAC ID: 2769881416 Enrollment ID: I20210528001463 |
| Provider Name | Joshua Klein Allen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730722059 PECOS PAC ID: 1355713421 Enrollment ID: I20230218000562 |
| Provider Name | Courtney Huey |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1346901477 PECOS PAC ID: 8628440799 Enrollment ID: I20231116002349 |
| Provider Name | Courtney April Ade |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174978324 PECOS PAC ID: 4486002730 Enrollment ID: I20231127001900 |
| Provider Name | Gwendolyn Beatrice Constantino |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003681412 PECOS PAC ID: 1759732100 Enrollment ID: I20240110001121 |
| Provider Name | Abigail Mccullough |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235822909 PECOS PAC ID: 2062851389 Enrollment ID: I20240419001372 |
| Provider Name | Jennifer Ann Coulson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295487791 PECOS PAC ID: 4880036557 Enrollment ID: I20240527000057 |
Mark Dearing,lcsw Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 12412 San Jose Blvd Ste 401, Jacksonville, FL 32223 Phone: 904-348-0343 | |
Reconnect Consulting Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3955 Riverside Ave, Jacksonville, FL 32205 Phone: 904-483-3843 | |
South Rehabilitation Center, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 580 Ellis Rd S, Suite 118, Jacksonville, FL 32254 Phone: 904-423-0017 Fax: 904-683-8169 | |
Mtb Therapist, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 6034 Chester Ave, Jacksonville, FL 32217 Phone: 904-323-2019 | |
Mc Medical Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 12100 Lem Turner Rd Unit 100, Jacksonville, FL 32218 Phone: 904-764-2855 Fax: 904-764-2670 | |
Westland Therapy Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6196 Lake Gray Blvd, Jacksonville, FL 32244 Phone: 718-483-5093 | |