| Counseling Dimensions | |
|
21075 Quesada Ave Port Charlotte United Methodist Chu Port Charlotte FL 33952 | |
| (941) 625-4356 | |
| Not Available |
| Full Name | Counseling Dimensions |
|---|---|
| Speciality | Counselor |
| Location | 21075 Quesada Ave, Port Charlotte, Florida |
| Authorized Official Name and Position | Wade M Warden (PRES/CEO) |
| Authorized Official Contact | 9414573442 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Counseling Dimensions 2186 Rio De Janeiro Punta Gorda FL 33983 Ph: (941) 457-3442 | Counseling Dimensions 21075 Quesada Ave Port Charlotte United Methodist Chu Port Charlotte FL 33952 Ph: (941) 625-4356 |
| NPI Number | 1063234219 |
|---|---|
| Provider Enumeration Date | 10/29/2024 |
| Last Update Date | 10/29/2024 |
| Certification Date | 10/25/2024 |
| Medicare PECOS PAC ID | 3072049774 |
|---|---|
| Medicare Enrollment ID | O20241204003765 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063234219 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Wade Manion Warden |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013773050 PECOS PAC ID: 4981130689 Enrollment ID: I20241204003964 |
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