| Purposeful Change Llc | |
|
6707 Plantation Rd Ste B3 Pensacola FL 32504-6216 | |
| (850) 207-7085 | |
| (850) 465-3255 |
| Full Name | Purposeful Change Llc |
|---|---|
| Speciality | Social Worker |
| Location | 6707 Plantation Rd Ste B3, Pensacola, Florida |
| Authorized Official Name and Position | Carmella Miller (OWNER) |
| Authorized Official Contact | 8503249864 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Purposeful Change Llc 3457 Marcus Pointe Blvd Pensacola FL 32505-1890 Ph: (850) 324-9864 | Purposeful Change Llc 6707 Plantation Rd Ste B3 Pensacola FL 32504-6216 Ph: (850) 207-7085 |
| NPI Number | 1245019066 |
|---|---|
| Provider Enumeration Date | 09/22/2023 |
| Last Update Date | 10/23/2023 |
| Certification Date | 10/23/2023 |
| Medicare PECOS PAC ID | 1850748468 |
|---|---|
| Medicare Enrollment ID | O20231103000403 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245019066 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Carmella Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689921157 PECOS PAC ID: 2769839372 Enrollment ID: I20231103000486 |
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