Life Management Center Of Nw Fl, Inc. | |
525 East 15th Street Panama City FL 32405-0000 | |
(850) 522-4485 | |
(850) 257-7967 |
Full Name | Life Management Center Of Nw Fl, Inc. |
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Speciality | Psychiatry & Neurology |
Location | 525 East 15th Street, Panama City, Florida |
Authorized Official Name and Position | Edwin R Ailes (CEO/PRESIDENT) |
Authorized Official Contact | 8505224485 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Life Management Center Of Nw Fl, Inc. 525 E 15th St Panama City FL 32405-5412 Ph: (850) 522-4485 | Life Management Center Of Nw Fl, Inc. 525 East 15th Street Panama City FL 32405-0000 Ph: (850) 522-4485 |
NPI Number | 1508854571 |
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Provider Enumeration Date | 10/12/2005 |
Last Update Date | 10/10/2024 |
Certification Date | 10/10/2024 |
Medicare PECOS PAC ID | 9739162371 |
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Medicare Enrollment ID | O20040612000387 |
Identifier | Type | State | Issuer |
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1508854571 | NPI | - | NPPES |
99260 | Other | FL | BLUE CROSS BLUE SHIELD |
060296500 | Medicaid | FL |
Provider Name | Guido Nodal |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1427064435 PECOS PAC ID: 7911999404 Enrollment ID: I20040402000684 |
Provider Name | Robert W Pollack |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1588816771 PECOS PAC ID: 3476600263 Enrollment ID: I20090414000282 |
Provider Name | Jerris N Grover |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1407002082 PECOS PAC ID: 8123178746 Enrollment ID: I20090602000535 |
Provider Name | Cheryl A Fields |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1659545697 PECOS PAC ID: 0648310599 Enrollment ID: I20091228000264 |
Provider Name | Cathy S Connor |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1063698025 PECOS PAC ID: 7719003573 Enrollment ID: I20100929000814 |
Provider Name | Vickie W Stephens |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1295047025 PECOS PAC ID: 2860684222 Enrollment ID: I20101005000115 |
Provider Name | Gabrielle K Blankenship |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1548251465 PECOS PAC ID: 3678765484 Enrollment ID: I20101012001154 |
Provider Name | David K Spillane |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1881909646 PECOS PAC ID: 5698960573 Enrollment ID: I20111006000649 |
Provider Name | Angelo P Herbu |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1265472096 PECOS PAC ID: 3971766528 Enrollment ID: I20120518000419 |
Provider Name | Paul H Wurst |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1366448615 PECOS PAC ID: 0840297966 Enrollment ID: I20120524000291 |
Provider Name | Kay L Norris |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1144534041 PECOS PAC ID: 7618165150 Enrollment ID: I20130306000599 |
Provider Name | Tiffany Washington-st Fort |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1487937207 PECOS PAC ID: 1355584541 Enrollment ID: I20130909000542 |
Provider Name | Angela Dawkins |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1538508643 PECOS PAC ID: 2769616481 Enrollment ID: I20131014000538 |
Provider Name | Patricia A Franko |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1285949156 PECOS PAC ID: 4183811987 Enrollment ID: I20131108000352 |
Provider Name | Arturo R Hernandez Pena |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1558526582 PECOS PAC ID: 8022332550 Enrollment ID: I20150109001853 |
Provider Name | Georgina Bembry |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881083947 PECOS PAC ID: 0648598862 Enrollment ID: I20150417001271 |
Provider Name | Lisa B Schoen |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1306879408 PECOS PAC ID: 7214126549 Enrollment ID: I20150427000451 |
Provider Name | Joan Vojtkofsky |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1689912958 PECOS PAC ID: 9234376427 Enrollment ID: I20151221000056 |
Provider Name | Jessica H Petch |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1225497282 PECOS PAC ID: 5991004418 Enrollment ID: I20160504000597 |
Provider Name | Phillip Burnett |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1699194027 PECOS PAC ID: 3072808930 Enrollment ID: I20160817001835 |
Provider Name | Svetlana Zoueva |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1992998009 PECOS PAC ID: 1052571619 Enrollment ID: I20170309000362 |
Provider Name | Dawn M Shepard |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1992259477 PECOS PAC ID: 2365729324 Enrollment ID: I20170501002158 |
Provider Name | Barton L Lewis |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1255397618 PECOS PAC ID: 2062459977 Enrollment ID: I20170509000352 |
Provider Name | Doris A Jones |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1275035198 PECOS PAC ID: 4183987209 Enrollment ID: I20180424000301 |
Provider Name | Marcia M Binion |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1477056943 PECOS PAC ID: 4284999848 Enrollment ID: I20180531001655 |
Provider Name | Ryan C Myers |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1942700182 PECOS PAC ID: 4880959352 Enrollment ID: I20180604002278 |
Provider Name | Luke T Chiou |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1063863546 PECOS PAC ID: 0244580140 Enrollment ID: I20180913000650 |
Provider Name | Sylvester I Smarty |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1497841464 PECOS PAC ID: 7810881281 Enrollment ID: I20190802000117 |
Provider Name | Pamela Faille |
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Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
Provider Identifiers | NPI Number: 1720009632 PECOS PAC ID: 2769466317 Enrollment ID: I20190911002037 |
Provider Name | Nancy L Gibson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1982695052 PECOS PAC ID: 5698719631 Enrollment ID: I20191115000266 |
Provider Name | Jennifer S Davis |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1801440763 PECOS PAC ID: 3173955903 Enrollment ID: I20191118001126 |
Provider Name | Rickman G Powers |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1770985855 PECOS PAC ID: 1254643851 Enrollment ID: I20200324000129 |
Provider Name | Kevin B Amiri |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1013377589 PECOS PAC ID: 1759712052 Enrollment ID: I20200520000720 |
Provider Name | Cheryl Elder |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1033725353 PECOS PAC ID: 3173934122 Enrollment ID: I20220624000462 |
Provider Name | Eleetka C Morrell |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1619697513 PECOS PAC ID: 0345611828 Enrollment ID: I20230119002232 |
Provider Name | Melanie Mcfarland Spoon |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1194061622 PECOS PAC ID: 4385909175 Enrollment ID: I20230511003657 |
Provider Name | Pamela Gilley |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1851001473 PECOS PAC ID: 3870957715 Enrollment ID: I20230912000999 |
Provider Name | Melissa Sims |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1063093060 PECOS PAC ID: 7810351533 Enrollment ID: I20230914000829 |
Provider Name | Melissa Chambers |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1265049670 PECOS PAC ID: 4587013115 Enrollment ID: I20231207004064 |
Provider Name | Robin Finley |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1013794924 PECOS PAC ID: 3971952490 Enrollment ID: I20231209000396 |
Provider Name | Chasity Cooper |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1619652112 PECOS PAC ID: 1759730187 Enrollment ID: I20231211003685 |
Provider Name | Laura Swalley |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1437398146 PECOS PAC ID: 6709235872 Enrollment ID: I20231214001795 |
Provider Name | Kerrie A Lewis |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1205221595 PECOS PAC ID: 9830549823 Enrollment ID: I20240103003129 |
Provider Name | Casey Whitman |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1053944124 PECOS PAC ID: 0143671131 Enrollment ID: I20240103003382 |
Provider Name | Shaun Phelps |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1275870495 PECOS PAC ID: 1557712122 Enrollment ID: I20240108004621 |
Provider Name | Penny Greene |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1316196231 PECOS PAC ID: 9537512678 Enrollment ID: I20240125001326 |
Provider Name | Sonni Sears |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1841744489 PECOS PAC ID: 4284087776 Enrollment ID: I20240131004294 |
Provider Name | Ashley Thornton |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1811538028 PECOS PAC ID: 3072956986 Enrollment ID: I20240207004269 |
Provider Name | Dawn N Carissan |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1134431240 PECOS PAC ID: 0143664276 Enrollment ID: I20240216002419 |
Provider Name | Julie Ann Bainbridge |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1073237210 PECOS PAC ID: 3274902234 Enrollment ID: I20240320001498 |
Provider Name | Elizabeth Lawrence |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1437768645 PECOS PAC ID: 2961843529 Enrollment ID: I20240514001026 |
Provider Name | William Wheaton |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1548694854 PECOS PAC ID: 7517344377 Enrollment ID: I20240517003143 |
Life Management Center Of Northwest Florida Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 525 E 15th St, Panama City, FL 32405 Phone: 850-522-4480 Fax: 850-914-6281 | |
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Unlimited Choices Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1011 Grace Ave, Panama City, FL 32401 Phone: 850-625-8266 | |
Journeypure Panhandle Medical Group Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 22219 Panama City Beach Pkwy, Panama City, FL 32413 Phone: 850-249-4300 | |
Thomas J. Derbes, M.d., Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Doctors Dr, Suite B, Panama City, FL 32405 Phone: 850-872-1300 Fax: 850-872-1300 |