| Emerald Springs Family Counseling Llc | |
|
81 St Hwy 83 N Ste A Defuniak Springs FL 32433-7487 | |
| (719) 286-3338 | |
| Not Available |
| Full Name | Emerald Springs Family Counseling Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 81 St Hwy 83 N Ste A, Defuniak Springs, Florida |
| Authorized Official Name and Position | Libby Renae Marcolongo (MARRIAGE AND FAMILY THERAPIST) |
| Authorized Official Contact | 7192863338 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Emerald Springs Family Counseling Llc 81 St Hwy 83 N Ste A Defuniak Springs FL 32433-7487 Ph: () - | Emerald Springs Family Counseling Llc 81 St Hwy 83 N Ste A Defuniak Springs FL 32433-7487 Ph: (719) 286-3338 |
| NPI Number | 1992566889 |
|---|---|
| Provider Enumeration Date | 01/18/2024 |
| Last Update Date | 01/18/2024 |
| Certification Date | 01/18/2024 |
| Medicare PECOS PAC ID | 9537504865 |
|---|---|
| Medicare Enrollment ID | O20240227001416 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992566889 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Libby Renae Marcolongo |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1265085096 PECOS PAC ID: 0446695779 Enrollment ID: I20240301001470 |
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