| Terry Mindfulness Center Llc | |
|
333 17th St Suite 2t Vero Beach FL 32960-5670 | |
| (772) 564-0406 | |
| Not Available |
| Full Name | Terry Mindfulness Center Llc |
|---|---|
| Speciality | Counselor |
| Location | 333 17th St, Vero Beach, Florida |
| Authorized Official Name and Position | Lisa Terry (PRESIDENT) |
| Authorized Official Contact | 7725640406 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Terry Mindfulness Center Llc 333 17th St Suite 2t Vero Beach FL 32960-5670 Ph: (772) 564-0406 | Terry Mindfulness Center Llc 333 17th St Suite 2t Vero Beach FL 32960-5670 Ph: (772) 564-0406 |
| NPI Number | 1063885499 |
|---|---|
| Provider Enumeration Date | 11/06/2015 |
| Last Update Date | 11/06/2015 |
| Medicare PECOS PAC ID | 2264733245 |
|---|---|
| Medicare Enrollment ID | O20151216001184 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063885499 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | SW4258 (Florida) | Primary |
| Provider Name | Lisa Terry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154345452 PECOS PAC ID: 1153306998 Enrollment ID: I20040624000055 |
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