| Santa Rosa Counseling Center Llc | |
|
5642 Jones St Milton FL 32570-2304 | |
| (850) 626-7779 | |
| (850) 626-7171 |
| Full Name | Santa Rosa Counseling Center Llc |
|---|---|
| Speciality | Counselor |
| Location | 5642 Jones St, Milton, Florida |
| Authorized Official Name and Position | Karen Alesia Willis (SENIOR PARTNER) |
| Authorized Official Contact | 8506267779 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Santa Rosa Counseling Center Llc 5642 Jones St Milton FL 32570-2304 Ph: (850) 626-7779 | Santa Rosa Counseling Center Llc 5642 Jones St Milton FL 32570-2304 Ph: (850) 626-7779 |
| NPI Number | 1962697441 |
|---|---|
| Provider Enumeration Date | 09/07/2007 |
| Last Update Date | 08/12/2022 |
| Certification Date | 06/10/2021 |
| Medicare PECOS PAC ID | 7012226061 |
|---|---|
| Medicare Enrollment ID | O20151014002147 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962697441 | NPI | - | NPPES |
| 103671100 | Medicaid | FL |
| Provider Name | Stephanie J Allan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326405598 PECOS PAC ID: 5395037741 Enrollment ID: I20160706000986 |
| Provider Name | Grace M Francis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023560471 PECOS PAC ID: 2264715788 Enrollment ID: I20170208000381 |
| Provider Name | Erin Haslag |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376107276 PECOS PAC ID: 0143645515 Enrollment ID: I20200731001967 |
| Provider Name | Megan Lawson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457927386 PECOS PAC ID: 5496156358 Enrollment ID: I20210629002758 |
| Provider Name | Casey Fletcher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265155667 PECOS PAC ID: 1456729896 Enrollment ID: I20221117002275 |
| Provider Name | Hannah Mcguire |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871993337 PECOS PAC ID: 7113361221 Enrollment ID: I20240216001750 |
| Provider Name | Jacob Michael Davis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770975625 PECOS PAC ID: 2062856099 Enrollment ID: I20240219000973 |
| Provider Name | Karen Alesia Willis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518096247 PECOS PAC ID: 0547579591 Enrollment ID: I20240220000603 |
| Provider Name | Jamie Greene |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952967226 PECOS PAC ID: 8022452598 Enrollment ID: I20240223000710 |
| Provider Name | Brian E Willis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740538511 PECOS PAC ID: 3375934755 Enrollment ID: I20240307000922 |
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