| Fort Myers Psychology, Pa | |
|
12791 World Plaza Ln Bldg 89 Fort Myers FL 33907-3989 | |
| (239) 829-5494 | |
| (239) 645-4777 |
| Full Name | Fort Myers Psychology, Pa |
|---|---|
| Speciality | Psychologist |
| Location | 12791 World Plaza Ln Bldg 89, Fort Myers, Florida |
| Authorized Official Name and Position | Brenda K Sluder (OFFICE BILLING ADMINISTRATOR) |
| Authorized Official Contact | 2398876004 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fort Myers Psychology, Pa 8430 Belle Meade Dr Fort Myers FL 33908-6009 Ph: (239) 826-7903 | Fort Myers Psychology, Pa 12791 World Plaza Ln Bldg 89 Fort Myers FL 33907-3989 Ph: (239) 829-5494 |
| NPI Number | 1003028119 |
|---|---|
| Provider Enumeration Date | 05/03/2007 |
| Last Update Date | 02/05/2024 |
| Certification Date | 02/05/2024 |
| Medicare PECOS PAC ID | 6204936305 |
|---|---|
| Medicare Enrollment ID | O20070702000495 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003028119 | NPI | - | NPPES |
| 74129 | Other | FL | BCBS FLORIDA |
| NJ5TQ | Other | FL | BCBS-FL BLUE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Nancy T Spencer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1073605747 PECOS PAC ID: 1355234857 Enrollment ID: I20040207000020 |
| Provider Name | Myra Marcus |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659352615 PECOS PAC ID: 5698740983 Enrollment ID: I20040901000141 |
| Provider Name | Gail Bialk |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003145384 PECOS PAC ID: 7012290471 Enrollment ID: I20170208002307 |
| Provider Name | Emily B Mcnally |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1801034145 PECOS PAC ID: 8426384686 Enrollment ID: I20190725000800 |
| Provider Name | Thomas J Barr |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1053336370 PECOS PAC ID: 8022012657 Enrollment ID: I20191105001688 |
| Provider Name | Keith Bauer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1770660193 PECOS PAC ID: 7416383401 Enrollment ID: I20210317001910 |
| Provider Name | Veronica Maria Rivera-velez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1164821039 PECOS PAC ID: 8224437215 Enrollment ID: I20210525000080 |
| Provider Name | Judith Jacques |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407894017 PECOS PAC ID: 4880607316 Enrollment ID: I20220623002678 |
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Health Planning Council Of Southwest Florida, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8961 Daniels Center Dr Ste 401, Fort Myers, FL 33912 Phone: 239-433-6700 | |
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