| Coffee With Jane, Pllc | |
|
4591 E Highway 20 Ste 202i Niceville FL 32578-8845 | |
| (850) 333-6828 | |
| (850) 254-9837 |
| Full Name | Coffee With Jane, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 4591 E Highway 20 Ste 202i, Niceville, Florida |
| Authorized Official Name and Position | Jane Ellen Davis (OWNER) |
| Authorized Official Contact | 8503336828 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coffee With Jane, Pllc 4516 E Highway 20 # 146 Niceville FL 32578-9755 Ph: (850) 333-6828 | Coffee With Jane, Pllc 4591 E Highway 20 Ste 202i Niceville FL 32578-8845 Ph: (850) 333-6828 |
| NPI Number | 1942921366 |
|---|---|
| Provider Enumeration Date | 09/05/2022 |
| Last Update Date | 09/05/2022 |
| Certification Date | 09/05/2022 |
| Medicare PECOS PAC ID | 2466811344 |
|---|---|
| Medicare Enrollment ID | O20230711000315 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942921366 | NPI | - | NPPES |
| Provider Name | Jane E Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659764694 PECOS PAC ID: 4688994593 Enrollment ID: I20150516000107 |
| Provider Name | Shannon Brunson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558479089 PECOS PAC ID: 2062852411 Enrollment ID: I20240501004143 |
| Provider Name | Dawn Kimball Key |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821681032 PECOS PAC ID: 7517307903 Enrollment ID: I20240502001364 |
| Provider Name | Cindy H Myers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467108704 PECOS PAC ID: 7315489572 Enrollment ID: I20240604001654 |
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