| Opal Sky Therapy Llc | |
|
121 Grande Berwick Ct Daytona Beach FL 32124-2100 | |
| (352) 600-4644 | |
| (386) 777-0442 |
| Full Name | Opal Sky Therapy Llc |
|---|---|
| Speciality | Social Worker |
| Location | 121 Grande Berwick Ct, Daytona Beach, Florida |
| Authorized Official Name and Position | Amanda Seiler-adams (OWNER/THERAPIST) |
| Authorized Official Contact | 5615732983 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Opal Sky Therapy Llc 121 Grande Berwick Ct Daytona Beach FL 32124-2100 Ph: (352) 600-4644 | Opal Sky Therapy Llc 121 Grande Berwick Ct Daytona Beach FL 32124-2100 Ph: (352) 600-4644 |
| NPI Number | 1588483473 |
|---|---|
| Provider Enumeration Date | 10/08/2024 |
| Last Update Date | 10/08/2024 |
| Certification Date | 10/07/2024 |
| Medicare PECOS PAC ID | 8325573843 |
|---|---|
| Medicare Enrollment ID | O20241121000077 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588483473 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Amanda Seiler-adams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417622325 PECOS PAC ID: 9234664756 Enrollment ID: I20241121000089 |
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