| Mandala Counseling Services Llc | |
|
6361 Presidential Ct Ste 101 Fort Myers FL 33919-3583 | |
| (239) 360-1976 | |
| Not Available |
| Full Name | Mandala Counseling Services Llc |
|---|---|
| Speciality | Counselor |
| Location | 6361 Presidential Ct Ste 101, Fort Myers, Florida |
| Authorized Official Name and Position | Brianna Kelly Jaworski (OWNER) |
| Authorized Official Contact | 9419629661 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mandala Counseling Services Llc 6361 Presidential Ct Ste 101 Fort Myers FL 33919-3583 Ph: (239) 360-1983 | Mandala Counseling Services Llc 6361 Presidential Ct Ste 101 Fort Myers FL 33919-3583 Ph: (239) 360-1976 |
| NPI Number | 1871134627 |
|---|---|
| Provider Enumeration Date | 10/02/2019 |
| Last Update Date | 10/28/2022 |
| Certification Date | 08/05/2022 |
| Medicare PECOS PAC ID | 7113366857 |
|---|---|
| Medicare Enrollment ID | O20240415002465 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871134627 | NPI | - | NPPES |
| 1932687167 | Other | LICENSED MENTAL HEALTH COUNSELOR |
| Provider Name | Brianna Jaworski |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932687167 PECOS PAC ID: 3476993924 Enrollment ID: I20240501000176 |
| Provider Name | Stephanie Kerns |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407323850 PECOS PAC ID: 1153763461 Enrollment ID: I20240531000474 |
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