| Gateway Community Services, Inc. | |
|
555 Stockton St Jacksonville FL 32204-2534 | |
| (904) 387-4661 | |
| (904) 384-5753 |
| Full Name | Gateway Community Services, Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 555 Stockton St, Jacksonville, Florida |
| Authorized Official Name and Position | Shawanda Holloway (UR/INSURANCE SPECIALIST) |
| Authorized Official Contact | 9043874661 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gateway Community Services, Inc. 555 Stockton St Jacksonville FL 32204-2534 Ph: (904) 387-4661 | Gateway Community Services, Inc. 555 Stockton St Jacksonville FL 32204-2534 Ph: (904) 387-4661 |
| NPI Number | 1356305338 |
|---|---|
| Provider Enumeration Date | 04/14/2006 |
| Last Update Date | 10/24/2023 |
| Certification Date | 10/24/2023 |
| Medicare PECOS PAC ID | 7618056649 |
|---|---|
| Medicare Enrollment ID | O20221207000679 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356305338 | NPI | - | NPPES |
| 060594800 | Medicaid | FL |
| Provider Name | Holly Magiera |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356487896 PECOS PAC ID: 3971698416 Enrollment ID: I20070928000512 |
| Provider Name | Raymond M Pomm |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659541654 PECOS PAC ID: 2365590833 Enrollment ID: I20090512000033 |
| Provider Name | Oliver N Oyama |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760432058 PECOS PAC ID: 2668507468 Enrollment ID: I20100318000588 |
| Provider Name | Beth A Gabriel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316543366 PECOS PAC ID: 0042625832 Enrollment ID: I20210208001964 |
| Provider Name | Divina M Pridham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962082693 PECOS PAC ID: 0840608287 Enrollment ID: I20210423000081 |
| Provider Name | Christina M Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699309989 PECOS PAC ID: 1951700954 Enrollment ID: I20210525000461 |
| Provider Name | Nancy Motherway |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548509219 PECOS PAC ID: 5496133621 Enrollment ID: I20230130002672 |
| Provider Name | Anne Frances Zawada |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740816198 PECOS PAC ID: 3577941707 Enrollment ID: I20230131001633 |
| Provider Name | Christina Marie Rust Seim |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417308487 PECOS PAC ID: 7315312790 Enrollment ID: I20230417003113 |
| Provider Name | Brandi Jackson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962157479 PECOS PAC ID: 3577932995 Enrollment ID: I20230424000182 |
| Provider Name | Nick Paul Tafuri |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811393499 PECOS PAC ID: 0446616916 Enrollment ID: I20230525002819 |
| Provider Name | Elizabeth Anne Clark |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588218150 PECOS PAC ID: 3678951803 Enrollment ID: I20230629002581 |
| Provider Name | Semir Karic |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265108633 PECOS PAC ID: 2860852118 Enrollment ID: I20230718002069 |
| Provider Name | Alvin Penix |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497420939 PECOS PAC ID: 8527414499 Enrollment ID: I20231030000040 |
| Provider Name | Shawanda Holloway |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285074203 PECOS PAC ID: 6204289598 Enrollment ID: I20240202002187 |
| Provider Name | George Rico Bodin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144998154 PECOS PAC ID: 2668850892 Enrollment ID: I20240225000126 |
| Provider Name | Jessica Leighanne Davis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699400986 PECOS PAC ID: 7810332814 Enrollment ID: I20240229002380 |
| Provider Name | Sarah Kristine Day |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811677743 PECOS PAC ID: 3375989536 Enrollment ID: I20240311000342 |
| Provider Name | Abigail Mccullough |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235822909 PECOS PAC ID: 2062851389 Enrollment ID: I20240419001372 |
| Provider Name | Kayla Jeanine Brewer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639800626 PECOS PAC ID: 1355782756 Enrollment ID: I20240516002012 |
| Provider Name | Nikeda Burphy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316376585 PECOS PAC ID: 1759769987 Enrollment ID: I20240526000038 |
| Provider Name | Candace Clark Hodgkins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033458708 PECOS PAC ID: 6305224536 Enrollment ID: I20240617001351 |
| Provider Name | Stacey Michelle Walston |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780369439 PECOS PAC ID: 3971046749 Enrollment ID: I20240620004229 |
| Provider Name | Kathlena N Reed |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750905253 PECOS PAC ID: 7719421320 Enrollment ID: I20240705002752 |
| Provider Name | Latoya Denise Davis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194017244 PECOS PAC ID: 9133668304 Enrollment ID: I20240902000003 |
| Provider Name | Candace Marie Spicer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134804818 PECOS PAC ID: 5991246712 Enrollment ID: I20240920000613 |
| Provider Name | Carrie-anne Keane |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396421012 PECOS PAC ID: 2961934252 Enrollment ID: I20241010004095 |
| Provider Name | Sabrina Zulqarnain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093578387 PECOS PAC ID: 2567994163 Enrollment ID: I20241021004233 |
| Provider Name | Danielle Renee Gallagher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548002884 PECOS PAC ID: 3678009024 Enrollment ID: I20241209001379 |
Mark Dearing,lcsw Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 12412 San Jose Blvd Ste 401, Jacksonville, FL 32223 Phone: 904-348-0343 | |
Reconnect Consulting Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3955 Riverside Ave, Jacksonville, FL 32205 Phone: 904-483-3843 | |
South Rehabilitation Center, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 580 Ellis Rd S, Suite 118, Jacksonville, FL 32254 Phone: 904-423-0017 Fax: 904-683-8169 | |
Mtb Therapist, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 6034 Chester Ave, Jacksonville, FL 32217 Phone: 904-323-2019 | |
Mc Medical Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 12100 Lem Turner Rd Unit 100, Jacksonville, FL 32218 Phone: 904-764-2855 Fax: 904-764-2670 | |
Westland Therapy Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6196 Lake Gray Blvd, Jacksonville, FL 32244 Phone: 718-483-5093 | |