Stillwaters Counseling Of Sw Florida Pllc | |
1720 El Jobean Rd Unit 106 Port Charlotte FL 33948-1286 | |
(941) 204-9038 | |
(941) 240-0091 |
Full Name | Stillwaters Counseling Of Sw Florida Pllc |
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Speciality | Counselor |
Location | 1720 El Jobean Rd Unit 106, Port Charlotte, Florida |
Authorized Official Name and Position | Deborah Jean Leahy (MANAGER/OWNER) |
Authorized Official Contact | 9412049038 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Stillwaters Counseling Of Sw Florida Pllc 1720 El Jobean Rd Unit 106 Port Charlotte FL 33948-1286 Ph: (941) 204-9038 | Stillwaters Counseling Of Sw Florida Pllc 1720 El Jobean Rd Unit 106 Port Charlotte FL 33948-1286 Ph: (941) 204-9038 |
NPI Number | 1376140343 |
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Provider Enumeration Date | 10/02/2020 |
Last Update Date | 11/07/2024 |
Certification Date | 11/07/2024 |
Medicare PECOS PAC ID | 4688194442 |
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Medicare Enrollment ID | O20250224001496 |
Identifier | Type | State | Issuer |
---|---|---|---|
1376140343 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Provider Name | Deborah Leahy |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1891269866 PECOS PAC ID: 3577085984 Enrollment ID: I20250320000553 |
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