| St. Croix Behavioral Health Center, Llc | |
|
113 Barren Spot The Village Mall Suite 107 Kingshill VI 00850 | |
| (340) 692-2600 | |
| (340) 692-2602 |
| Full Name | St. Croix Behavioral Health Center, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 113 Barren Spot, Kingshill, Virgin Island |
| Authorized Official Name and Position | Jewel V. Owen (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 3406922600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Croix Behavioral Health Center, Llc 113 Barren Spot The Village Mall Suite 107 Kingshill VI 00850 Ph: (340) 692-2600 | St. Croix Behavioral Health Center, Llc 113 Barren Spot The Village Mall Suite 107 Kingshill VI 00850 Ph: (340) 692-2600 |
| NPI Number | 1255601951 |
|---|---|
| Provider Enumeration Date | 01/11/2012 |
| Last Update Date | 01/11/2012 |
| Medicare PECOS PAC ID | 4880829605 |
|---|---|
| Medicare Enrollment ID | O20131106000215 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255601951 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 2-14664-1L (Virgin Island) | Primary |
| Provider Name | Jewel V Owen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1679554364 PECOS PAC ID: 9335126150 Enrollment ID: I20090102000068 |
Virgin Island Neurology, Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 254-a Estate Glenn, Kingshill, VI 00850 Phone: 340-642-5705 |