| Lorien | |
|
151 Mary Esther Blvd Suite 201 Mary Esther FL 32569-1972 | |
| (850) 862-6030 | |
| (850) 862-6030 |
| Full Name | Lorien |
|---|---|
| Speciality | Counselor |
| Location | 151 Mary Esther Blvd, Mary Esther, Florida |
| Authorized Official Name and Position | Joseph P. Skelly (CEO, CFO) |
| Authorized Official Contact | 8508626030 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lorien 151 Mary Esther Blvd Suite 201 Mary Esther FL 32569-1972 Ph: (850) 862-6030 | Lorien 151 Mary Esther Blvd Suite 201 Mary Esther FL 32569-1972 Ph: (850) 862-6030 |
| NPI Number | 1710185012 |
|---|---|
| Provider Enumeration Date | 07/07/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 5395793665 |
|---|---|
| Medicare Enrollment ID | O20200827001848 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710185012 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MH0003140 (Florida) | Primary |
| Provider Name | Joseph Skelly |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417901133 PECOS PAC ID: 0648228916 Enrollment ID: I20240206004840 |
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