| J Churchwell Counseling | |
|
2200 N Ponce De Leon Blvd Ste 3 St Augustine FL 32084-2650 | |
| (904) 377-4200 | |
| (904) 485-8019 |
| Full Name | J Churchwell Counseling |
|---|---|
| Speciality | Social Worker |
| Location | 2200 N Ponce De Leon Blvd Ste 3, St Augustine, Florida |
| Authorized Official Name and Position | Jill Yoerger-churchwell (OWNER) |
| Authorized Official Contact | 9043774200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| J Churchwell Counseling 2200 N Ponce De Leon Blvd Ste 3 St Augustine FL 32084-2650 Ph: (904) 377-4200 | J Churchwell Counseling 2200 N Ponce De Leon Blvd Ste 3 St Augustine FL 32084-2650 Ph: (904) 377-4200 |
| NPI Number | 1922501493 |
|---|---|
| Provider Enumeration Date | 03/12/2018 |
| Last Update Date | 11/07/2024 |
| Certification Date | 11/07/2024 |
| Medicare PECOS PAC ID | 0446500748 |
|---|---|
| Medicare Enrollment ID | O20180907000706 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922501493 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jill Anette Yoerger-churchwell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629417472 PECOS PAC ID: 3173750783 Enrollment ID: I20131205000646 |
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