| Beach Street Counseling, Llc | |
|
140 S Beach St Ste 414 Daytona Beach FL 32114-4472 | |
| (386) 299-0026 | |
| Not Available |
| Full Name | Beach Street Counseling, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 140 S Beach St Ste 414, Daytona Beach, Florida |
| Authorized Official Name and Position | Jeannie Jenuwine (OWNER) |
| Authorized Official Contact | 3862990026 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beach Street Counseling, Llc 140 S Beach St Ste 414 Daytona Beach FL 32114-4472 Ph: (386) 299-0026 | Beach Street Counseling, Llc 140 S Beach St Ste 414 Daytona Beach FL 32114-4472 Ph: (386) 299-0026 |
| NPI Number | 1841072600 |
|---|---|
| Provider Enumeration Date | 10/17/2023 |
| Last Update Date | 10/17/2023 |
| Certification Date | 10/17/2023 |
| Medicare PECOS PAC ID | 1153765359 |
|---|---|
| Medicare Enrollment ID | O20240215002253 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841072600 | NPI | - | NPPES |
| 1851672646 | Other | MI | NPI |
| Provider Name | Jeannie Jenuwine |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851672646 PECOS PAC ID: 5395074900 Enrollment ID: I20240215002500 |
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