| Stony Brook Counseling Center Inc | |
|
7491 W Oakland Park Blvd Ste 308 Tamarac FL 33319-4966 | |
| (954) 746-5667 | |
| (954) 746-6387 |
| Full Name | Stony Brook Counseling Center Inc |
|---|---|
| Speciality | Counselor |
| Location | 7491 W Oakland Park Blvd Ste 308, Tamarac, Florida |
| Authorized Official Name and Position | John P. Molinari (PRESIDENT) |
| Authorized Official Contact | 9547465667 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stony Brook Counseling Center Inc 7491 W Oakland Park Blvd Ste 308 Tamarac FL 33319-4966 Ph: (954) 746-5667 | Stony Brook Counseling Center Inc 7491 W Oakland Park Blvd Ste 308 Tamarac FL 33319-4966 Ph: (954) 746-5667 |
| NPI Number | 1669579884 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 12/05/2023 |
| Certification Date | 12/05/2023 |
| Medicare PECOS PAC ID | 2769566975 |
|---|---|
| Medicare Enrollment ID | O20080227000199 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669579884 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | SW1454 (Florida) | Primary |
| Provider Name | Carol L Gwaltney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750432860 PECOS PAC ID: 2961589668 Enrollment ID: I20080404000590 |
| Provider Name | Elana M Polsyn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568810844 PECOS PAC ID: 3678857307 Enrollment ID: I20170224001164 |
| Provider Name | Monica Zarate |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1992711139 PECOS PAC ID: 2668490814 Enrollment ID: I20231202000710 |
| Provider Name | Melanie Mcmillion |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013493022 PECOS PAC ID: 2961851308 Enrollment ID: I20231212000226 |
| Provider Name | Luisa Elizabeth Villagomez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053018218 PECOS PAC ID: 5890145551 Enrollment ID: I20231221002315 |
| Provider Name | Ieshy L Gales |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396253373 PECOS PAC ID: 0244680726 Enrollment ID: I20231226000034 |
| Provider Name | Janus Moncur |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962956953 PECOS PAC ID: 5193063279 Enrollment ID: I20231229001253 |
| Provider Name | Judy L. Couwels |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1407062086 PECOS PAC ID: 3971955790 Enrollment ID: I20240117003454 |
| Provider Name | Susan Boklaga |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528111457 PECOS PAC ID: 7012352354 Enrollment ID: I20240227001663 |
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