Elmer Wiscovitch, | |
439 Sw Michigan St, Lake City, FL 32025-0440 | |
(386) 487-0800 | |
Not Available |
Full Name | Elmer Wiscovitch |
---|---|
Gender | Male |
Speciality | Counselor - Mental Health |
Location | 439 Sw Michigan St, Lake City, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1346851136 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101Y00000X | Counselor | (* (Not Available)) | Secondary |
101YM0800X | Counselor - Mental Health | 21380 (Florida) | Primary |
Entity Name | Grow Healthcare Group Pa |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20210414000053 |
Mailing Address | Practice Location Address |
---|---|
Elmer Wiscovitch, 411 Nw 95th. Way, Gainesville, FL 32607 Ph: (352) 870-1526 | Elmer Wiscovitch, 439 Sw Michigan St, Lake City, FL 32025-0440 Ph: (386) 487-0800 |
Amber Brisa Moss, RMHCI Counselor Medicare: Not Enrolled in Medicare Practice Location: 922 Sw Baya Dr, Lake City, FL 32025 Phone: 386-754-9005 Fax: 386-754-9017 | |
Darcy Pare, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 439 Sw Michigan St, Lake City, FL 32025 Phone: 352-374-5600 | |
Bethanne Mccarron, Counselor Medicare: Not Enrolled in Medicare Practice Location: 439 Sw Michigan St, Lake City, FL 32025 Phone: 352-374-5600 | |
Marilyn Hamm, Counselor Medicare: Not Enrolled in Medicare Practice Location: 439 Sw Michigan St, Lake City, FL 32025 Phone: 386-487-0800 | |
Pawel Lazarczyk, M.S. Counselor Medicare: Not Enrolled in Medicare Practice Location: 922 Sw Baya Dr, Lake City, FL 32025 Phone: 386-754-9005 | |
Shonda Latricia Hart, Counselor Medicare: Not Enrolled in Medicare Practice Location: 439 Sw Michigan St, Lake City, FL 32025 Phone: 386-487-0800 | |
Lillian Carla Keys, Counselor Medicare: Not Enrolled in Medicare Practice Location: 439 Sw Michigan St, Lake City, FL 32025 Phone: 386-487-0800 |