| Marvellous Behavioral Health And Mediation, Llc | |
|
1015 Grace Ave Ste B Panama City FL 32401-2494 | |
| (850) 215-1808 | |
| (850) 215-1895 |
| Full Name | Marvellous Behavioral Health And Mediation, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1015 Grace Ave Ste B, Panama City, Florida |
| Authorized Official Name and Position | Marvel L. Estes (OWNER) |
| Authorized Official Contact | 8506247898 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Marvellous Behavioral Health And Mediation, Llc 1015 Grace Ave Ste B Panama City FL 32401-2494 Ph: (850) 215-1808 | Marvellous Behavioral Health And Mediation, Llc 1015 Grace Ave Ste B Panama City FL 32401-2494 Ph: (850) 215-1808 |
| NPI Number | 1831600618 |
|---|---|
| Provider Enumeration Date | 10/19/2017 |
| Last Update Date | 02/21/2024 |
| Certification Date | 02/21/2024 |
| Medicare PECOS PAC ID | 1355786872 |
|---|---|
| Medicare Enrollment ID | O20240223002854 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831600618 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | MH12363 (Florida) | Primary |
| Provider Name | Marvel Levy Estes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043639610 PECOS PAC ID: 2264877786 Enrollment ID: I20240223002913 |
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