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160 Nw Central Park Plz Ste 104 Port St Lucie FL 34986-1825 | |
| (772) 361-6778 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 160 Nw Central Park Plz Ste 104, Port St Lucie, Florida |
| Authorized Official Name and Position | Justin Kalel Baksh (CEO) |
| Authorized Official Contact | 7726176373 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
160 Nw Central Park Plz Ste 105 Port St Lucie FL 34986-1825 Ph: (772) 497-5985 | 160 Nw Central Park Plz Ste 104 Port St Lucie FL 34986-1825 Ph: (772) 361-6778 |
| NPI Number | 1720759954 |
|---|---|
| Provider Enumeration Date | 09/27/2021 |
| Last Update Date | 11/18/2024 |
| Certification Date | 11/18/2024 |
| Medicare PECOS PAC ID | 4981097318 |
|---|---|
| Medicare Enrollment ID | O20220622001573 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720759954 | NPI | - | NPPES |
| Provider Name | Joanna Vanvleet |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154535292 PECOS PAC ID: 0840467213 Enrollment ID: I20120607000302 |
| Provider Name | Natalie Nina Jagarnauth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215681994 PECOS PAC ID: 9436515871 Enrollment ID: I20230510000752 |
| Provider Name | Jennifer Sees |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033624002 PECOS PAC ID: 4284080060 Enrollment ID: I20231031001176 |
| Provider Name | Kenesha Shashana Ricketts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285312157 PECOS PAC ID: 4880041706 Enrollment ID: I20231114001044 |
| Provider Name | Maggie Votteler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124667035 PECOS PAC ID: 8022552157 Enrollment ID: I20240701001779 |
| Provider Name | Yolonda Pawielski |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437938008 PECOS PAC ID: 1759821648 Enrollment ID: I20240905004618 |
| Provider Name | Alyssa Townsend |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780422568 PECOS PAC ID: 2466993530 Enrollment ID: I20240917004001 |
| Provider Name | Jackie Frances Nalley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225485493 PECOS PAC ID: 9234660242 Enrollment ID: I20241001004411 |
| Provider Name | Justin K Baksh |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447618590 PECOS PAC ID: 5890188221 Enrollment ID: I20241022004825 |
Kris Parker & Associates Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1950 Se Port St Lucie Blvd, Suite 205, Port St Lucie, FL 34952 Phone: 772-224-2125 Fax: 772-224-2290 | |
Florida Community Health Centers, Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 9576 S Us Highway 1, Port St Lucie, FL 34952 Phone: 561-844-9443 | |
Strive Health & Wellness Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1874 Se Port St Lucie Blvd, Port St Lucie, FL 34952 Phone: 772-353-1410 Fax: 772-673-8134 | |
Harmony House Recovery Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 810 Nw Greenwich Ct, Port St Lucie, FL 34983 Phone: 772-924-4163 | |
Global Behavioral Solutions Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 406 Se Cork Rd, Port St Lucie, FL 34984 Phone: 954-873-4039 | |
Mind & Body Counseling Institute Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1949 Sw Idaho Ln, Port St Lucie, FL 34953 Phone: 772-233-6295 |