| Smart Living Coaching Services Llc | |
|
6050 34th St W Apt 121 Bradenton FL 34210-3602 | |
| (480) 323-9742 | |
| Not Available |
| Full Name | Smart Living Coaching Services Llc |
|---|---|
| Speciality | Psychologist |
| Location | 6050 34th St W Apt 121, Bradenton, Florida |
| Authorized Official Name and Position | Nathan White (OWNER) |
| Authorized Official Contact | 4803239742 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Smart Living Coaching Services Llc Po Box 2062 Sarasota FL 34230-2062 Ph: () - | Smart Living Coaching Services Llc 6050 34th St W Apt 121 Bradenton FL 34210-3602 Ph: (480) 323-9742 |
| NPI Number | 1457892895 |
|---|---|
| Provider Enumeration Date | 03/18/2017 |
| Last Update Date | 09/14/2023 |
| Certification Date | 09/14/2023 |
| Medicare PECOS PAC ID | 2163778796 |
|---|---|
| Medicare Enrollment ID | O20180711003039 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457892895 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | PY8659 (Florida) | Primary |
| Provider Name | Nathan James White |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700123536 PECOS PAC ID: 6002059102 Enrollment ID: I20130821000165 |
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