| Lifecounselor.net | |
|
600 N Pine Island Rd Suite 450 Plantation FL 33324-1393 | |
| (954) 559-2936 | |
| Not Available |
| Full Name | Lifecounselor.net |
|---|---|
| Speciality | Clinic/Center |
| Location | 600 N Pine Island Rd, Plantation, Florida |
| Authorized Official Name and Position | Chantal M Gagnon (CEO) |
| Authorized Official Contact | 9545592936 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifecounselor.net 7378 W Atlantic Blvd Suite 388 Margate FL 33063-4214 Ph: (954) 559-2936 | Lifecounselor.net 600 N Pine Island Rd Suite 450 Plantation FL 33324-1393 Ph: (954) 559-2936 |
| NPI Number | 1770746851 |
|---|---|
| Provider Enumeration Date | 07/08/2008 |
| Last Update Date | 07/08/2008 |
| Medicare PECOS PAC ID | 3971853565 |
|---|---|
| Medicare Enrollment ID | O20180831000269 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770746851 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | MH9510 (Florida) | Primary |
| Provider Name | Chantal M Gagnon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790948867 PECOS PAC ID: 5496005829 Enrollment ID: I20240507001334 |
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