| Actions 4 Life | |
|
2685 Formosa Ter The Villages FL 32162-2117 | |
| (941) 782-7195 | |
| (877) 307-6399 |
| Full Name | Actions 4 Life |
|---|---|
| Speciality | Psychologist |
| Location | 2685 Formosa Ter, The Villages, Florida |
| Authorized Official Name and Position | Joanne Pitera Studer (PRESIDENT) |
| Authorized Official Contact | 9417827195 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Actions 4 Life 2685 Formosa Ter The Villages FL 32162-2117 Ph: (941) 782-7195 | Actions 4 Life 2685 Formosa Ter The Villages FL 32162-2117 Ph: (941) 782-7195 |
| NPI Number | 1053582080 |
|---|---|
| Provider Enumeration Date | 03/18/2008 |
| Last Update Date | 08/18/2016 |
| Medicare PECOS PAC ID | 8123189867 |
|---|---|
| Medicare Enrollment ID | O20081212000468 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053582080 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PY 4421 (Florida) | Primary |
| Provider Name | Nathalie Austion Ivory |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245392422 PECOS PAC ID: 9032213137 Enrollment ID: I20070329000408 |
| Provider Name | Ashley M. Paxton-watts |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730227174 PECOS PAC ID: 7416192224 Enrollment ID: I20130327000466 |
| Provider Name | David Charles Congdon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588815617 PECOS PAC ID: 8123379997 Enrollment ID: I20180919000053 |
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