Foundations Counseling, Llc. | |
1299 Bedford Dr Ste B2 Melbourne FL 32940-1900 | |
(321) 537-6034 | |
(321) 547-4046 |
Full Name | Foundations Counseling, Llc. |
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Speciality | Community/Behavioral Health |
Location | 1299 Bedford Dr Ste B2, Melbourne, Florida |
Authorized Official Name and Position | Rayna Bravo (EXECUTIVE DIRECTOR/OWNER) |
Authorized Official Contact | 3216228104 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Foundations Counseling, Llc. 1299 Bedford Dr Ste B2 Melbourne FL 32940-1900 Ph: (321) 622-8104 | Foundations Counseling, Llc. 1299 Bedford Dr Ste B2 Melbourne FL 32940-1900 Ph: (321) 537-6034 |
NPI Number | 1366090730 |
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Provider Enumeration Date | 08/29/2019 |
Last Update Date | 02/08/2023 |
Certification Date | 02/08/2023 |
Medicare PECOS PAC ID | 6305230137 |
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Medicare Enrollment ID | O20220222000072 |
Identifier | Type | State | Issuer |
---|---|---|---|
1366090730 | NPI | - | NPPES |
1316226756 | Other | HUMANA | |
1316226756 | Other | CIGNA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Provider Name | Tracy Lynn Newman |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1093320707 PECOS PAC ID: 9931593761 Enrollment ID: I20220222000088 |
Provider Name | Rayna M Bravo |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1316226756 PECOS PAC ID: 5496103764 Enrollment ID: I20231127002600 |
Provider Name | Glori Borges |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1144509522 PECOS PAC ID: 7517315633 Enrollment ID: I20231130001535 |
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