| Community Wellness Counseling And Support Services | |
|
10611 Nw State Road 20 Bristol FL 32321-3441 | |
| (850) 643-1033 | |
| (850) 643-5066 |
| Full Name | Community Wellness Counseling And Support Services |
|---|---|
| Speciality | Social Worker |
| Location | 10611 Nw State Road 20, Bristol, Florida |
| Authorized Official Name and Position | Winter Lynn Collins (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 8506437724 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Wellness Counseling And Support Services 10611 Nw State Road 20 Bristol FL 32321-3441 Ph: (850) 643-1033 | Community Wellness Counseling And Support Services 10611 Nw State Road 20 Bristol FL 32321-3441 Ph: (850) 643-1033 |
| NPI Number | 1881047041 |
|---|---|
| Provider Enumeration Date | 07/22/2016 |
| Last Update Date | 09/18/2024 |
| Certification Date | 09/18/2024 |
| Medicare PECOS PAC ID | 1759628324 |
|---|---|
| Medicare Enrollment ID | O20190122000908 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881047041 | NPI | - | NPPES |
| 020917500 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | SW11921 (Florida) | Primary |
| 252Y00000X | Early Intervention Provider Agency | SW11921 (Florida) | Secondary |
| Provider Name | Winter L Collins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538573423 PECOS PAC ID: 2163769746 Enrollment ID: I20190122001195 |
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