| Justin Conrad Koenitzer, PSYD | |
|
220 Barton Blvd, Unit C14, Rockledge, FL 32955-2742 | |
| (321) 639-5177 | |
| (321) 639-4927 |
| Full Name | Justin Conrad Koenitzer |
|---|---|
| Gender | Male |
| Speciality | Clinical Psychologist |
| Experience | 17 Years |
| Location | 220 Barton Blvd, Rockledge, Florida |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578824421 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY8536 (Florida) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Optum Behavioral Care Of North Carolina Pc | 5092120030 | 161 |
| Entity Name | Refresh Canopy Cove, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1730661752 PECOS PAC ID: 3779822119 Enrollment ID: O20190304000354 |
| Entity Name | Optum Behavioral Care Of North Carolina Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1033984448 PECOS PAC ID: 5092120030 Enrollment ID: O20240401000110 |
| Mailing Address | Practice Location Address |
|---|---|
| Justin Conrad Koenitzer, PSYD Po Box 1137, Melbourne, FL 32902-1137 Ph: (321) 952-9696 | Justin Conrad Koenitzer, PSYD 220 Barton Blvd, Unit C14, Rockledge, FL 32955-2742 Ph: (321) 639-5177 |
Jonelle Ensign, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 590 Solutions Way Ste 110, Rockledge, FL 32955 Phone: 321-305-4342 | |
Elizabeth Chadwick Burns, PSY.D. Psychologist Medicare: Medicare Enrolled Practice Location: 220 Barton Blvd Unit C14, Rockledge, FL 32955 Phone: 321-639-5177 Fax: 321-639-4927 | |
Robyn Carroll-yenko, M.S., NCSP Psychologist Medicare: Not Enrolled in Medicare Practice Location: 107 Oakledge Dr, Rockledge, FL 32955 Phone: 407-412-4105 |