Panhandle Therapy Center Llc | |
20311 Central Ave W Blountstown FL 32424-1947 | |
(850) 674-8888 | |
(850) 237-1223 |
Full Name | Panhandle Therapy Center Llc |
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Speciality | Clinic/Center |
Location | 20311 Central Ave W, Blountstown, Florida |
Authorized Official Name and Position | Heather Montford King (DIRECTOR) |
Authorized Official Contact | 8504474546 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Panhandle Therapy Center Llc 20311 Central Ave W Blountstown FL 32424-1947 Ph: (850) 674-8888 | Panhandle Therapy Center Llc 20311 Central Ave W Blountstown FL 32424-1947 Ph: (850) 674-8888 |
NPI Number | 1457981888 |
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Provider Enumeration Date | 01/24/2020 |
Last Update Date | 07/11/2024 |
Certification Date | 07/11/2024 |
Medicare PECOS PAC ID | 0446672489 |
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Medicare Enrollment ID | O20200622001928 |
Identifier | Type | State | Issuer |
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1457981888 | NPI | - | NPPES |
Provider Name | Heather M King |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1992040034 PECOS PAC ID: 9335394329 Enrollment ID: I20130222000410 |
Provider Name | Christina K Oliva |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1548607088 PECOS PAC ID: 5799926390 Enrollment ID: I20130724000514 |
Provider Name | Glenn Graves |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1487848842 PECOS PAC ID: 8527229905 Enrollment ID: I20190212001072 |
Provider Name | Jordon Marissa Gilbert |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1215441290 PECOS PAC ID: 4587078894 Enrollment ID: I20210128000305 |
Provider Name | Edward Bennett |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1467035410 PECOS PAC ID: 7012373145 Enrollment ID: I20230516002344 |
Provider Name | Maggie Mccaskill Foran |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1770355232 PECOS PAC ID: 6709233158 Enrollment ID: I20231107003468 |
Provider Name | Jason Glenn Tucker |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1194073601 PECOS PAC ID: 6406207844 Enrollment ID: I20240110000629 |
Provider Name | Kenneth F Speights |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1871967786 PECOS PAC ID: 2163874322 Enrollment ID: I20240123004734 |
Life Management Center Of Northwest Florida Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 16869 Ne Pear St, Blountstown, FL 32424 Phone: 850-522-4480 Fax: 850-914-6281 |