| John Chaffin, Ed.d., P.a. | |
|
2312 Wilton Dr Ste 24 Wilton Manors FL 33305-1249 | |
| (954) 380-8823 | |
| Not Available |
| Full Name | John Chaffin, Ed.d., P.a. |
|---|---|
| Speciality | Counselor |
| Location | 2312 Wilton Dr Ste 24, Wilton Manors, Florida |
| Authorized Official Name and Position | John Chaffin (LICENSED PSYCHOTHERAPIST) |
| Authorized Official Contact | 9543808823 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| John Chaffin, Ed.d., P.a. 2312 Wilton Drive Suite 24 Wilton Manors FL 33305 Ph: (954) 380-8823 | John Chaffin, Ed.d., P.a. 2312 Wilton Dr Ste 24 Wilton Manors FL 33305-1249 Ph: (954) 380-8823 |
| NPI Number | 1861918260 |
|---|---|
| Provider Enumeration Date | 08/17/2017 |
| Last Update Date | 08/27/2017 |
| Medicare PECOS PAC ID | 2860835501 |
|---|---|
| Medicare Enrollment ID | O20240208004488 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861918260 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MH13783 (Florida) | Primary |
| Provider Name | John Edwards Chaffin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114353893 PECOS PAC ID: 3779926415 Enrollment ID: I20240208004511 |
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