Patricia Lynn Klocko, LMHC | |
728 Ne 7th St, Trenton, FL 32693-3637 | |
(352) 374-5600 | |
Not Available |
Full Name | Patricia Lynn Klocko |
---|---|
Gender | Female |
Speciality | Counselor |
Location | 728 Ne 7th St, Trenton, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1700557030 | NPI | - | NPPES |
MH24009 | Other | FL | FLORIDA BOARD OF CLINICAL SOCIAL WORK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101Y00000X | Counselor | MH24009 (Florida) | Primary |
101Y00000X | Counselor | (* (Not Available)) | Secondary |
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 |
---|---|
Patricia Lynn Klocko, LMHC 3469 Se 80th Ave, Newberry, FL 32669-7001 Ph: (352) 221-0369 | Patricia Lynn Klocko, LMHC 728 Ne 7th St, Trenton, FL 32693-3637 Ph: (352) 374-5600 |
Leesha London, Counselor Medicare: Not Enrolled in Medicare Practice Location: 728 Ne 7th Street, Trenton, FL 32693 Phone: 352-487-0064 | |
Amber Rollison, Counselor Medicare: Not Enrolled in Medicare Practice Location: 728 Ne 7th St, Trenton, FL 32693 Phone: 352-374-5600 | |
Natalie Charde Johnson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 728 Ne 7th St, Trenton, FL 32693 Phone: 352-487-0064 | |
Ruby Sepulveda, Counselor Medicare: Not Enrolled in Medicare Practice Location: 728 Ne 7th St, Trenton, FL 32693 Phone: 352-374-5600 | |
Ms. Virginia Taylor Stegall, EDS, LMHC, AND LMFT Counselor Medicare: Medicare Enrolled Practice Location: 728 Ne 7th St, Trenton, FL 32693 Phone: 352-487-0064 Fax: 352-244-0464 | |
Shantasia R Pack, Counselor Medicare: Not Enrolled in Medicare Practice Location: 728 Ne 7th St, Trenton, FL 32693 Phone: 352-374-5600 | |
Jennifer Fleurmont, Counselor Medicare: Not Enrolled in Medicare Practice Location: 728 Ne 7th St, Trenton, FL 32693 Phone: 352-374-5600 |