Mr Scott Thomas Bleakley, LCSW | |
1530 Celebration Blvd Ste 405, Celebration, FL 34747-5165 | |
(833) 769-3524 | |
Not Available |
Full Name | Mr Scott Thomas Bleakley |
---|---|
Gender | Male |
Speciality | Social Worker - Clinical |
Location | 1530 Celebration Blvd Ste 405, Celebration, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1013072008 | NPI | - | NPPES |
30423171 | Medicaid | NH | |
P08033 | Other | MA | BCBS |
144001431NH02 | Other | NH | BCBS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 1071 (New Hampshire) | Secondary |
1041C0700X | Social Worker - Clinical | SW21441 (Florida) | Primary |
Entity Name | Personal Recovery Network Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1881990869 PECOS PAC ID: 5092611384 Enrollment ID: O20200416000590 |
Mailing Address | Practice Location Address |
---|---|
Mr Scott Thomas Bleakley, LCSW 160 Lafayette Rd Apt 1, North Hampton, NH 03862-2420 Ph: (603) 370-0168 | Mr Scott Thomas Bleakley, LCSW 1530 Celebration Blvd Ste 405, Celebration, FL 34747-5165 Ph: (833) 769-3524 |
Daniel F. Mawhinney, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1500 Resolute St, Celebration, FL 34747 Phone: 603-845-7134 | |
Katherine Gomatos, MSW, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 400 Celebration Pl, Celebration, FL 34747 Phone: 407-495-0624 |