| Lucidity Mental Health Llc | |
|
747 Jenks Ave Ste C Panama City FL 32401-2570 | |
| (850) 215-4060 | |
| (850) 695-9176 |
| Full Name | Lucidity Mental Health Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 747 Jenks Ave Ste C, Panama City, Florida |
| Authorized Official Name and Position | Lisa Marie Harris (OWNER) |
| Authorized Official Contact | 8502154060 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lucidity Mental Health Llc 747 Jenks Ave Ste C Panama City FL 32401-2570 Ph: (850) 215-4060 | Lucidity Mental Health Llc 747 Jenks Ave Ste C Panama City FL 32401-2570 Ph: (850) 215-4060 |
| NPI Number | 1184366007 |
|---|---|
| Provider Enumeration Date | 04/11/2022 |
| Last Update Date | 04/11/2022 |
| Certification Date | 04/11/2022 |
| Medicare PECOS PAC ID | 1951798958 |
|---|---|
| Medicare Enrollment ID | O20220421001002 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184366007 | NPI | - | NPPES |
| 1609395110 | Other | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Lisa M Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609395110 PECOS PAC ID: 1456601269 Enrollment ID: I20210527000993 |
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