| Ocala Consulting & Prevention, Llc | |
|
2303 Se 17th St Ste 102 Ocala FL 34471-9109 | |
| (352) 622-4488 | |
| (352) 565-2196 |
| Full Name | Ocala Consulting & Prevention, Llc |
|---|---|
| Speciality | Counselor |
| Location | 2303 Se 17th St Ste 102, Ocala, Florida |
| Authorized Official Name and Position | Jackie Gibson-jacobowitz (CEO) |
| Authorized Official Contact | 3526224488 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ocala Consulting & Prevention, Llc 2303 Se 17th St Ste 102 Ocala FL 34471-9109 Ph: (352) 622-4488 | Ocala Consulting & Prevention, Llc 2303 Se 17th St Ste 102 Ocala FL 34471-9109 Ph: (352) 622-4488 |
| NPI Number | 1770916264 |
|---|---|
| Provider Enumeration Date | 08/20/2013 |
| Last Update Date | 09/09/2021 |
| Certification Date | 09/09/2021 |
| Medicare PECOS PAC ID | 4981020757 |
|---|---|
| Medicare Enrollment ID | O20200812000125 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770916264 | NPI | - | NPPES |
| Z02F4 | Other | FL | BCBS PROVIDER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MH10396 (Florida) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| Provider Name | Rene Seuntjens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164859179 PECOS PAC ID: 7113343997 Enrollment ID: I20200812000269 |
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