| Beach Therapy Consulting | |
|
12701 Cinqueterre Dr Venice FL 34293-4076 | |
| (201) 675-7151 | |
| Not Available |
| Full Name | Beach Therapy Consulting |
|---|---|
| Speciality | Social Worker |
| Location | 12701 Cinqueterre Dr, Venice, Florida |
| Authorized Official Name and Position | Stacy Lang (OWNER) |
| Authorized Official Contact | 2016757151 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beach Therapy Consulting 12701 Cinqueterre Dr Venice FL 34293-4076 Ph: (201) 675-7151 | Beach Therapy Consulting 12701 Cinqueterre Dr Venice FL 34293-4076 Ph: (201) 675-7151 |
| NPI Number | 1912627266 |
|---|---|
| Provider Enumeration Date | 08/29/2022 |
| Last Update Date | 09/14/2022 |
| Certification Date | 09/14/2022 |
| Medicare PECOS PAC ID | 1658747480 |
|---|---|
| Medicare Enrollment ID | O20221020000017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912627266 | NPI | - | NPPES |
| 19212 | Other | FL | LCSW |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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