| New Creation Counseling And Therapeutic Bodywork Inc | |
|
5878 Mizpah Ct Lakeland FL 33810-1841 | |
| (630) 207-5537 | |
| (888) 873-1159 |
| Full Name | New Creation Counseling And Therapeutic Bodywork Inc |
|---|---|
| Speciality | Counselor |
| Location | 5878 Mizpah Ct, Lakeland, Florida |
| Authorized Official Name and Position | Pamela Diane Trice (PRESIDENT) |
| Authorized Official Contact | 6302075537 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Creation Counseling And Therapeutic Bodywork Inc 5878 Mizpah Ct Lakeland FL 33810-1841 Ph: (630) 207-5537 | New Creation Counseling And Therapeutic Bodywork Inc 5878 Mizpah Ct Lakeland FL 33810-1841 Ph: (630) 207-5537 |
| NPI Number | 1558125468 |
|---|---|
| Provider Enumeration Date | 02/12/2024 |
| Last Update Date | 02/13/2024 |
| Certification Date | 02/13/2024 |
| Medicare PECOS PAC ID | 5698110245 |
|---|---|
| Medicare Enrollment ID | O20240305002541 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558125468 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Pamela Diane Trice |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134181902 PECOS PAC ID: 7214383587 Enrollment ID: I20240305002741 |
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