| Rise Counseling Treasure Coast | |
|
1680 Se Lyngate Dr Ste 204 Port Saint Lucie FL 34952-4300 | |
| (772) 226-0383 | |
| Not Available |
| Full Name | Rise Counseling Treasure Coast |
|---|---|
| Speciality | Counselor |
| Location | 1680 Se Lyngate Dr Ste 204, Port Saint Lucie, Florida |
| Authorized Official Name and Position | Stephanie Sammons (OWNER) |
| Authorized Official Contact | 7722260383 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rise Counseling Treasure Coast 1680 Se Lyngate Dr Ste 204 Port Saint Lucie FL 34952-4300 Ph: () - | Rise Counseling Treasure Coast 1680 Se Lyngate Dr Ste 204 Port Saint Lucie FL 34952-4300 Ph: (772) 226-0383 |
| NPI Number | 1205617941 |
|---|---|
| Provider Enumeration Date | 10/09/2023 |
| Last Update Date | 10/09/2023 |
| Certification Date | 10/09/2023 |
| Medicare PECOS PAC ID | 5890130892 |
|---|---|
| Medicare Enrollment ID | O20240229002492 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205617941 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Stephanie Sammons |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114696804 PECOS PAC ID: 5698110609 Enrollment ID: I20240229002668 |
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