| Florida Counseling Network Llc | |
|
533 N Nova Rd Ste 114 Ormond Beach FL 32174-4421 | |
| (386) 227-7014 | |
| Not Available |
| Full Name | Florida Counseling Network Llc |
|---|---|
| Speciality | Counselor |
| Location | 533 N Nova Rd Ste 114, Ormond Beach, Florida |
| Authorized Official Name and Position | Julie Baker (OWNER) |
| Authorized Official Contact | 3867853065 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Florida Counseling Network Llc 533 N Nova Rd Ste 114 Ormond Beach FL 32174-4421 Ph: (386) 227-7014 | Florida Counseling Network Llc 533 N Nova Rd Ste 114 Ormond Beach FL 32174-4421 Ph: (386) 227-7014 |
| NPI Number | 1821584202 |
|---|---|
| Provider Enumeration Date | 07/09/2018 |
| Last Update Date | 07/03/2021 |
| Certification Date | 07/03/2021 |
| Medicare PECOS PAC ID | 0840544789 |
|---|---|
| Medicare Enrollment ID | O20181113002093 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821584202 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
| Provider Name | Anna Marie Grono |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144793084 PECOS PAC ID: 7719217991 Enrollment ID: I20191002000097 |
| Provider Name | Sharnice White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780295667 PECOS PAC ID: 4284045402 Enrollment ID: I20201119001149 |
| Provider Name | Yesenia Maria Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194458802 PECOS PAC ID: 5698159101 Enrollment ID: I20220901001803 |
| Provider Name | Carllisa Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124515440 PECOS PAC ID: 1052780145 Enrollment ID: I20221213000109 |
| Provider Name | Steven C Vangelder |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1023102779 PECOS PAC ID: 3870942873 Enrollment ID: I20231215003308 |
| Provider Name | Wallace Scott Shearon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568422533 PECOS PAC ID: 0648621474 Enrollment ID: I20240105002721 |
| Provider Name | Bette Brock Rutan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407416050 PECOS PAC ID: 2567813827 Enrollment ID: I20240110005189 |
| Provider Name | Chhaya Johnson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447269261 PECOS PAC ID: 5496071847 Enrollment ID: I20240110005241 |
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