Inner Resource Psychotherapy, Llc | |
140 The Lakes Blvd Ste 225 Kingsland GA 31548-5667 | |
(904) 310-4325 | |
(904) 895-6057 |
Full Name | Inner Resource Psychotherapy, Llc |
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Speciality | Community/Behavioral Health |
Location | 140 The Lakes Blvd Ste 225, Kingsland, Georgia |
Authorized Official Name and Position | Amy Beth Otzel (SOLE MANAGER/MEMBER & COUNSELOR) |
Authorized Official Contact | 9043104325 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Inner Resource Psychotherapy, Llc 140 The Lakes Blvd Ste 225 Kingsland GA 31548-5667 Ph: (904) 310-4325 | Inner Resource Psychotherapy, Llc 140 The Lakes Blvd Ste 225 Kingsland GA 31548-5667 Ph: (904) 310-4325 |
NPI Number | 1023408622 |
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Provider Enumeration Date | 02/03/2015 |
Last Update Date | 07/17/2024 |
Certification Date | 07/17/2024 |
Medicare PECOS PAC ID | 6901243773 |
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Medicare Enrollment ID | O20240328002280 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023408622 | NPI | - | NPPES |
Provider Name | Amy Beth Otzel |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1154747699 PECOS PAC ID: 7719324581 Enrollment ID: I20240328003436 |
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