| Beachside Mental Health Counseling Services | |
|
5050 Ocean Beach Blvd Apt 103 Cocoa Beach FL 32931-3762 | |
| (321) 323-9302 | |
| (888) 354-4711 |
| Full Name | Beachside Mental Health Counseling Services |
|---|---|
| Speciality | Social Worker |
| Location | 5050 Ocean Beach Blvd Apt 103, Cocoa Beach, Florida |
| Authorized Official Name and Position | Martha K Fay (OWNER) |
| Authorized Official Contact | 3213239302 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beachside Mental Health Counseling Services 5050 Ocean Beach Blvd Apt 103 Cocoa Beach FL 32931-3762 Ph: (321) 323-9302 | Beachside Mental Health Counseling Services 5050 Ocean Beach Blvd Apt 103 Cocoa Beach FL 32931-3762 Ph: (321) 323-9302 |
| NPI Number | 1578103925 |
|---|---|
| Provider Enumeration Date | 01/14/2020 |
| Last Update Date | 02/15/2021 |
| Certification Date | 02/15/2021 |
| Medicare PECOS PAC ID | 6709292188 |
|---|---|
| Medicare Enrollment ID | O20210309003298 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578103925 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| Provider Name | Martha Kinman Fay |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316109838 PECOS PAC ID: 6800202284 Enrollment ID: I20210309003262 |
| Provider Name | Ashley Nicole Cumbess |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639836935 PECOS PAC ID: 2668820788 Enrollment ID: I20231130001706 |
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