| Ocean Vista Counseling, Llc | |
|
1452 N Us Highway 1 Ormond Beach FL 32174 | |
| (386) 449-8600 | |
| (386) 313-6980 |
| Full Name | Ocean Vista Counseling, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1452 N Us Highway 1, Ormond Beach, Florida |
| Authorized Official Name and Position | Kathleen Coughlin (MANAGING MEMBER) |
| Authorized Official Contact | 3864498600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ocean Vista Counseling, Llc 1452 N Us Highway 1 Ste 127 Ormond Beach FL 32174-6638 Ph: (386) 449-8600 | Ocean Vista Counseling, Llc 1452 N Us Highway 1 Ormond Beach FL 32174 Ph: (386) 449-8600 |
| NPI Number | 1760980502 |
|---|---|
| Provider Enumeration Date | 01/26/2018 |
| Last Update Date | 05/15/2018 |
| Medicare PECOS PAC ID | 1355605163 |
|---|---|
| Medicare Enrollment ID | O20180502002650 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760980502 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | SW14331 (Florida) | Primary |
| Provider Name | Kathleen Coughlin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396759874 PECOS PAC ID: 0840360384 Enrollment ID: I20180502002844 |
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