| Joel G Prather Psy.d, P.a. | |
|
12133 Panama City Beach Pkwy Panama City Beach FL 32407-2609 | |
| (850) 249-9636 | |
| (850) 249-9635 |
| Full Name | Joel G Prather Psy.d, P.a. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 12133 Panama City Beach Pkwy, Panama City Beach, Florida |
| Authorized Official Name and Position | Joel G Prather (PRESIDENT) |
| Authorized Official Contact | 8502499736 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Joel G Prather Psy.d, P.a. 12133 Panama City Beach Pkwy Panama City Beach FL 32407-2609 Ph: (850) 249-9636 | Joel G Prather Psy.d, P.a. 12133 Panama City Beach Pkwy Panama City Beach FL 32407-2609 Ph: (850) 249-9636 |
| NPI Number | 1477729895 |
|---|---|
| Provider Enumeration Date | 05/06/2008 |
| Last Update Date | 12/16/2024 |
| Certification Date | 12/11/2024 |
| Medicare PECOS PAC ID | 1052856911 |
|---|---|
| Medicare Enrollment ID | O20240716000506 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477729895 | NPI | - | NPPES |
| 768539400 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MH9104 (Florida) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Joel G Prather |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063633444 PECOS PAC ID: 9830634716 Enrollment ID: I20240716001459 |
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