| Sage & Lore Counseling | |
|
1404 Del Prado Blvd S Cape Coral FL 33990-3774 | |
| (978) 310-1212 | |
| Not Available |
| Full Name | Sage & Lore Counseling |
|---|---|
| Speciality | Counselor |
| Location | 1404 Del Prado Blvd S, Cape Coral, Florida |
| Authorized Official Name and Position | Petra P Wilkes (THERAPIST) |
| Authorized Official Contact | 9783101212 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sage & Lore Counseling 4085 Hancock Bridge Pkwy Ste 112-116 North Fort Myers FL 33903-7219 Ph: () - | Sage & Lore Counseling 1404 Del Prado Blvd S Cape Coral FL 33990-3774 Ph: (978) 310-1212 |
| NPI Number | 1811754997 |
|---|---|
| Provider Enumeration Date | 03/05/2024 |
| Last Update Date | 03/05/2024 |
| Certification Date | 03/05/2024 |
| Medicare PECOS PAC ID | 6305283615 |
|---|---|
| Medicare Enrollment ID | O20240322000320 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811754997 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Petra P Wilkes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225890387 PECOS PAC ID: 2264879576 Enrollment ID: I20240322000594 |
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