| Cordova Counseling Center | |
|
4400 Bayou Boulevard Suite 8 Pensacola FL 32503 | |
| (850) 474-9882 | |
| (850) 479-1821 |
| Full Name | Cordova Counseling Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 4400 Bayou Boulevard, Pensacola, Florida |
| Authorized Official Name and Position | John E Bingham (PRESIDENT) |
| Authorized Official Contact | 8504749882 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cordova Counseling Center 4400 Bayou Boulevard Suite 8 Pensacola FL 32503 Ph: (850) 474-9882 | Cordova Counseling Center 4400 Bayou Boulevard Suite 8 Pensacola FL 32503 Ph: (850) 474-9882 |
| NPI Number | 1336260678 |
|---|---|
| Provider Enumeration Date | 04/03/2007 |
| Last Update Date | 07/15/2008 |
| Medicare PECOS PAC ID | 7719050517 |
|---|---|
| Medicare Enrollment ID | O20160504001561 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336260678 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Brett W Turner |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1114074127 PECOS PAC ID: 6608949409 Enrollment ID: I20080725000530 |
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