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920 W Government St Pensacola FL 32502-5308 | |
| (508) 078-0114 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 920 W Government St, Pensacola, Florida |
| Authorized Official Name and Position | Devin Elise Lovelace (PRESIDENT) |
| Authorized Official Contact | 8503809841 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
920 W Government St Pensacola FL 32502-5308 Ph: (850) 807-0114 | 920 W Government St Pensacola FL 32502-5308 Ph: (508) 078-0114 |
| NPI Number | 1891426458 |
|---|---|
| Provider Enumeration Date | 06/23/2022 |
| Last Update Date | 08/05/2022 |
| Certification Date | 08/05/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891426458 | NPI | - | NPPES |
| 1770803140 | Medicaid | FL | |
| 1366007536 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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