| James Berwick, Lcsw | |
|
505 22nd St St Augustine FL 32084-1798 | |
| (904) 599-3602 | |
| (904) 461-8368 |
| Full Name | James Berwick, Lcsw |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 505 22nd St, St Augustine, Florida |
| Authorized Official Name and Position | James Berwick (OWNER/OPERATOR) |
| Authorized Official Contact | 9045993602 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| James Berwick, Lcsw 505 22nd St St Augustine FL 32084-1798 Ph: (904) 599-3602 | James Berwick, Lcsw 505 22nd St St Augustine FL 32084-1798 Ph: (904) 599-3602 |
| NPI Number | 1659666543 |
|---|---|
| Provider Enumeration Date | 06/19/2011 |
| Last Update Date | 06/19/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659666543 | NPI | - | NPPES |
| 761949900 | Medicaid | FL | |
| Z4535 | Other | FL | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | SW1692 (Florida) | Primary |
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