| Redefine Your Story, Llc | |
|
3707 Pompano Dr Pensacola FL 32514-4736 | |
| (850) 483-1331 | |
| (850) 361-3437 |
| Full Name | Redefine Your Story, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 3707 Pompano Dr, Pensacola, Florida |
| Authorized Official Name and Position | Stacey Christine Steele-taylor (CLINICAL SOCIAL WORKER THERAPIST) |
| Authorized Official Contact | 8504831331 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Redefine Your Story, Llc 3707 Pompano Dr Pensacola FL 32514-4736 Ph: (850) 483-1331 | Redefine Your Story, Llc 3707 Pompano Dr Pensacola FL 32514-4736 Ph: (850) 483-1331 |
| NPI Number | 1881116374 |
|---|---|
| Provider Enumeration Date | 07/17/2017 |
| Last Update Date | 07/21/2022 |
| Certification Date | 09/13/2021 |
| Medicare PECOS PAC ID | 4688932569 |
|---|---|
| Medicare Enrollment ID | O20171226000456 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881116374 | NPI | - | NPPES |
| 1184050197 | Other | FL | STACEY STEELE-TAYLOR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | SW11591 (Florida) | Primary |
| Provider Name | Stacey Christine Steele-taylor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184050197 PECOS PAC ID: 6608002225 Enrollment ID: I20131203001818 |
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