| West Orange Counseling Llc | |
|
301 N Tubb St Oakland FL 34760-1225 | |
| (407) 877-8074 | |
| (407) 877-0410 |
| Full Name | West Orange Counseling Llc |
|---|---|
| Speciality | Social Worker |
| Location | 301 N Tubb St, Oakland, Florida |
| Authorized Official Name and Position | Jeffrey David Gill (OWNER) |
| Authorized Official Contact | 4078778074 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| West Orange Counseling Llc Po Box 1225 301 N Tubb St Oakland FL 34760-1225 Ph: (407) 877-8074 | West Orange Counseling Llc 301 N Tubb St Oakland FL 34760-1225 Ph: (407) 877-8074 |
| NPI Number | 1538295860 |
|---|---|
| Provider Enumeration Date | 02/23/2007 |
| Last Update Date | 01/23/2014 |
| Medicare PECOS PAC ID | 7517972169 |
|---|---|
| Medicare Enrollment ID | O20060217000519 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538295860 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | SW3983 (Florida) | Secondary |
| 1041C0700X | Social Worker - Clinical | SW3983 (Florida) | Primary |
| Provider Name | Jeffrey Gill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972643674 PECOS PAC ID: 1951344357 Enrollment ID: I20050607000439 |
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