Altagrace K Souverain, LCSW | |
2140 N Don Wickham Dr, Clermont, FL 34711-1922 | |
(352) 394-5922 | |
Not Available |
Full Name | Altagrace K Souverain |
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Gender | Female |
Speciality | Social Worker - Clinical |
Location | 2140 N Don Wickham Dr, Clermont, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1003533423 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1041C0700X | Social Worker - Clinical | SW20568 (Florida) | Primary |
Entity Name | Lifestream Behavioral Center Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1902802002 PECOS PAC ID: 7012992720 Enrollment ID: O20040618000512 |
Mailing Address | Practice Location Address |
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Altagrace K Souverain, LCSW Po Box 491000, Leesburg, FL 34749-1000 Ph: (352) 315-7500 | Altagrace K Souverain, LCSW 2140 N Don Wickham Dr, Clermont, FL 34711-1922 Ph: (352) 394-5922 |
Pamela Quiroz, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 509 Cagan View Rd, Clermont, FL 34714 Phone: 407-905-8827 Fax: 407-905-8998 | |
Massiel Hernandez, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 4300 S Hwy 27 Ste 205b, Clermont, FL 34711 Phone: 407-374-5139 | |
Rona Ingrid Henriques, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 450 E Highway 50, Clermont, FL 34711 Phone: 352-432-2127 Fax: 352-432-2127 | |
Alyssa Bellin, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2400 S Hwy 27 Ste B201, Clermont, FL 34711 Phone: 727-254-9092 | |
Joelle June Bangsund, MSW, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 835 Oakley Seaver Dr, S, Clermont, FL 34711 Phone: 352-241-9282 Fax: 352-241-4282 | |
Andrea Clemens, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 14806 Spruce Pine Ln, Clermont, FL 34711 Phone: 407-486-1086 |