| Eight Winds Wellness, Llc | |
|
7901 4th St N Ste 300 St Petersburg FL 33702-4399 | |
| (617) 500-7527 | |
| Not Available |
| Full Name | Eight Winds Wellness, Llc |
|---|---|
| Speciality | Counselor |
| Location | 7901 4th St N Ste 300, St Petersburg, Florida |
| Authorized Official Name and Position | Charlotte Johnson (OWNER) |
| Authorized Official Contact | 6175007527 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eight Winds Wellness, Llc 7901 4th St N Ste 300 St Petersburg FL 33702-4399 Ph: () - | Eight Winds Wellness, Llc 7901 4th St N Ste 300 St Petersburg FL 33702-4399 Ph: (617) 500-7527 |
| NPI Number | 1104691872 |
|---|---|
| Provider Enumeration Date | 11/22/2023 |
| Last Update Date | 11/22/2023 |
| Certification Date | 11/22/2023 |
| Medicare PECOS PAC ID | 1658713086 |
|---|---|
| Medicare Enrollment ID | O20240530001466 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104691872 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Charlotte Johnson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790193373 PECOS PAC ID: 3072964733 Enrollment ID: I20240530001581 |
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