| Seasons Psychotherapy Associates Llc | |
|
12505 Orange Dr Ste 901 Davie FL 33330-4300 | |
| (954) 342-0982 | |
| (954) 342-1080 |
| Full Name | Seasons Psychotherapy Associates Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 12505 Orange Dr Ste 901, Davie, Florida |
| Authorized Official Name and Position | Carol Mirones (PARTNER) |
| Authorized Official Contact | 9543420982 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Seasons Psychotherapy Associates Llc 2601 E Oakland Park Blvd Ste 205 Fort Lauderdale FL 33306-1658 Ph: (954) 342-0982 | Seasons Psychotherapy Associates Llc 12505 Orange Dr Ste 901 Davie FL 33330-4300 Ph: (954) 342-0982 |
| NPI Number | 1639796675 |
|---|---|
| Provider Enumeration Date | 06/25/2020 |
| Last Update Date | 07/13/2022 |
| Certification Date | 07/13/2022 |
| Medicare PECOS PAC ID | 6608286943 |
|---|---|
| Medicare Enrollment ID | O20201028000379 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639796675 | NPI | - | NPPES |
| 108602800 | Medicaid | FL |
| Provider Name | Eileen Nancy Grove |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306481213 PECOS PAC ID: 0345666970 Enrollment ID: I20200813001724 |
| Provider Name | Carol Lipscomb Mirones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528681137 PECOS PAC ID: 4789094020 Enrollment ID: I20201216000497 |
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