| Beachside Recovery Interventions & Consulting Llc | |
|
1640 Highway A1a Ste C Satellite Beach FL 32937-5451 | |
| (321) 978-4041 | |
| Not Available |
| Full Name | Beachside Recovery Interventions & Consulting Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1640 Highway A1a Ste C, Satellite Beach, Florida |
| Authorized Official Name and Position | Drew David Breznitsky (OWNER) |
| Authorized Official Contact | 3219784041 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beachside Recovery Interventions & Consulting Llc 1640 Highway A1a Ste C Satellite Beach FL 32937-5451 Ph: (321) 978-4041 | Beachside Recovery Interventions & Consulting Llc 1640 Highway A1a Ste C Satellite Beach FL 32937-5451 Ph: (321) 978-4041 |
| NPI Number | 1427725126 |
|---|---|
| Provider Enumeration Date | 08/30/2021 |
| Last Update Date | 08/30/2021 |
| Certification Date | 08/30/2021 |
| Medicare PECOS PAC ID | 2961891072 |
|---|---|
| Medicare Enrollment ID | O20211111000696 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427725126 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Bethann Mahoney |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104990217 PECOS PAC ID: 2264424936 Enrollment ID: I20131218000793 |
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