Ingrid Pinto De Otazu, LMHC | |
751 Ashbury Ave, Melbourne, FL 32940 | |
(321) 960-1015 | |
Not Available |
Full Name | Ingrid Pinto De Otazu |
---|---|
Gender | Female |
Speciality | Counselor - Mental Health |
Location | 751 Ashbury Ave, Melbourne, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1851752992 | NPI | - | NPPES |
1629483706 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | MH19704 (Florida) | Primary |
Entity Name | Healing Alliance Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1053063735 PECOS PAC ID: 8426493099 Enrollment ID: O20240305003351 |
Mailing Address | Practice Location Address |
---|---|
Ingrid Pinto De Otazu, LMHC 751 Ashbury Ave, Melbourne, FL 32940 Ph: (321) 960-1015 | Ingrid Pinto De Otazu, LMHC 751 Ashbury Ave, Melbourne, FL 32940 Ph: (321) 960-1015 |
Michelle Cannon, MSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 326 Croton Rd, Melbourne, FL 32935 Phone: 321-752-3170 Fax: 321-752-3179 | |
Bryanna Oswalt, Counselor Medicare: Not Enrolled in Medicare Practice Location: 4450 W Eau Gallie Blvd, Suite 200, Melbourne, FL 32934 Phone: 321-726-2860 | |
Mrs. Jennifer Lovell, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 3345 Delaney Dr Apt 101, Melbourne, FL 32934 Phone: 321-557-1888 | |
Angela Bryan, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3270 Suntree Blvd Ste 103a, Melbourne, FL 32940 Phone: 321-757-4015 | |
Ms. J. Phyllis Brannen, LCSW, CAP Counselor Medicare: Medicare Enrolled Practice Location: 1503 Pine St, Melbourne, FL 32901 Phone: 321-953-3225 Fax: 321-953-3252 | |
Anne Wolfram, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 3040 N Wickham Rd, Suite 3, Melbourne, FL 32935 Phone: 321-254-3042 Fax: 321-254-4770 | |
Mrs. Kwanya Toussaint, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 3270 Suntree Blvd Ste 127, Melbourne, FL 32940 Phone: 321-610-7949 Fax: 321-610-7947 |