| Footprints In The Sand Counseling Services, Llc | |
|
2600 N Highlands Blvd Bldg 1000 Avon Park FL 33825-9331 | |
| (863) 572-2992 | |
| Not Available |
| Full Name | Footprints In The Sand Counseling Services, Llc |
|---|---|
| Speciality | Counselor |
| Location | 2600 N Highlands Blvd Bldg 1000, Avon Park, Florida |
| Authorized Official Name and Position | Kathryn Neff Perry (OWNER) |
| Authorized Official Contact | 8632573346 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Footprints In The Sand Counseling Services, Llc 1004 N Anoka Ave Avon Park FL 33825-2506 Ph: (863) 257-3346 | Footprints In The Sand Counseling Services, Llc 2600 N Highlands Blvd Bldg 1000 Avon Park FL 33825-9331 Ph: (863) 572-2992 |
| NPI Number | 1417718727 |
|---|---|
| Provider Enumeration Date | 01/23/2024 |
| Last Update Date | 02/01/2024 |
| Certification Date | 02/01/2024 |
| Medicare PECOS PAC ID | 3971963711 |
|---|---|
| Medicare Enrollment ID | O20240209001614 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417718727 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Kathryn N Perry |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356997902 PECOS PAC ID: 3678930708 Enrollment ID: I20231201000077 |
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