| Creative Path Counseling Llc | |
|
16069 Tampa St Brooksville FL 34604-8458 | |
| (203) 706-9325 | |
| Not Available |
| Full Name | Creative Path Counseling Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 16069 Tampa St, Brooksville, Florida |
| Authorized Official Name and Position | Lina Lacasse (PRESIDENT) |
| Authorized Official Contact | 2037069325 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Creative Path Counseling Llc 16069 Tampa St Brooksville FL 34604-8458 Ph: (203) 706-9325 | Creative Path Counseling Llc 16069 Tampa St Brooksville FL 34604-8458 Ph: (203) 706-9325 |
| NPI Number | 1629652078 |
|---|---|
| Provider Enumeration Date | 05/11/2021 |
| Last Update Date | 05/11/2021 |
| Certification Date | 05/11/2021 |
| Medicare PECOS PAC ID | 8729473384 |
|---|---|
| Medicare Enrollment ID | O20220316004134 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629652078 | NPI | - | NPPES |
| L220-520-68-662-0 | Other | FL | FLORIDA DRIVER LICENSE |
| Provider Name | Sara Blomeling- Deroo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487081782 PECOS PAC ID: 3870729213 Enrollment ID: I20211007000182 |
| Provider Name | Sari Elissa Cohen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194332502 PECOS PAC ID: 2769833847 Enrollment ID: I20240112003420 |
| Provider Name | Anita Rogers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144771544 PECOS PAC ID: 9638564297 Enrollment ID: I20240116000017 |
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