| Gainesville Community Counseling Center | |
|
3850 Nw 83rd St Ste 201 Gainesville FL 32606-5601 | |
| (352) 448-9120 | |
| Not Available |
| Full Name | Gainesville Community Counseling Center |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 3850 Nw 83rd St Ste 201, Gainesville, Florida |
| Authorized Official Name and Position | Larry Green (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3524489120 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gainesville Community Counseling Center 3850 Nw 83rd St Ste 201 Gainesville FL 32606-5601 Ph: (352) 448-9120 | Gainesville Community Counseling Center 3850 Nw 83rd St Ste 201 Gainesville FL 32606-5601 Ph: (352) 448-9120 |
| NPI Number | 1710470851 |
|---|---|
| Provider Enumeration Date | 06/13/2018 |
| Last Update Date | 05/21/2024 |
| Certification Date | 05/21/2024 |
| Medicare PECOS PAC ID | 9830548676 |
|---|---|
| Medicare Enrollment ID | O20231206000032 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710470851 | NPI | - | NPPES |
| MT2733 | Other | FL | FLORIDA DEPARTMENT OF HEALTH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Larry Green |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1619281979 PECOS PAC ID: 1557736998 Enrollment ID: I20231221002750 |
| Provider Name | Eliane Fuentes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871178590 PECOS PAC ID: 5890146575 Enrollment ID: I20240106000418 |
| Provider Name | Sabrina Nichole Williams |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1972110997 PECOS PAC ID: 1850743873 Enrollment ID: I20240116001109 |
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