| Indenpendent Contractor For Counseling Services | |
|
1606 Tennessee Ave Lynn Haven FL 32444-3653 | |
| (850) 814-5060 | |
| (850) 265-1811 |
| Full Name | Indenpendent Contractor For Counseling Services |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1606 Tennessee Ave, Lynn Haven, Florida |
| Authorized Official Name and Position | Lourdes M. Sanchez-rodriguez (OWNER/SOLE PROPRIETATOR) |
| Authorized Official Contact | 8508145060 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Indenpendent Contractor For Counseling Services 608 Sommer Cir Panama City FL 32405-3224 Ph: (850) 814-5060 | Indenpendent Contractor For Counseling Services 1606 Tennessee Ave Lynn Haven FL 32444-3653 Ph: (850) 814-5060 |
| NPI Number | 1205223328 |
|---|---|
| Provider Enumeration Date | 04/16/2015 |
| Last Update Date | 04/16/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205223328 | NPI | - | NPPES |
| 763657100 | Medicaid | FL | |
| 811551600 | Other | FL | MEDICAID- DEVELOPMENTAL SPECIALIST |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MH4860 (Florida) | Primary |
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