| Gulfside Counseling And Wellness | |
|
1101 Gulf Breeze Pkw Bldg 2, Ste 4 Gulf Breeze FL 32561-4891 | |
| (850) 203-0045 | |
| Not Available |
| Full Name | Gulfside Counseling And Wellness |
|---|---|
| Speciality | Social Worker |
| Location | 1101 Gulf Breeze Pkw, Gulf Breeze, Florida |
| Authorized Official Name and Position | Stephanie S Peterson (OWNER) |
| Authorized Official Contact | 8502613951 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gulfside Counseling And Wellness 1101 Gulf Breeze Pkw Bldg 2, Ste 4 Gulf Breeze FL 32561-4891 Ph: (850) 203-0045 | Gulfside Counseling And Wellness 1101 Gulf Breeze Pkw Bldg 2, Ste 4 Gulf Breeze FL 32561-4891 Ph: (850) 203-0045 |
| NPI Number | 1831886514 |
|---|---|
| Provider Enumeration Date | 04/21/2023 |
| Last Update Date | 04/16/2024 |
| Certification Date | 06/28/2023 |
| Medicare PECOS PAC ID | 6709328586 |
|---|---|
| Medicare Enrollment ID | O20240607002098 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831886514 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Stephanie S Peterson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033672621 PECOS PAC ID: 0547597296 Enrollment ID: I20190805000305 |
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