| The Journey Forward Counseling Center Llc | |
|
1600 W Eau Gallie Blvd Ste 201h Melbourne FL 32935-4149 | |
| (772) 202-8811 | |
| Not Available |
| Full Name | The Journey Forward Counseling Center Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1600 W Eau Gallie Blvd Ste 201h, Melbourne, Florida |
| Authorized Official Name and Position | Tiffiny Overath (OWNER) |
| Authorized Official Contact | 7722028811 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Journey Forward Counseling Center Llc 1600 W Eau Gallie Blvd Ste 201h Melbourne FL 32935-4149 Ph: (772) 202-8811 | The Journey Forward Counseling Center Llc 1600 W Eau Gallie Blvd Ste 201h Melbourne FL 32935-4149 Ph: (772) 202-8811 |
| NPI Number | 1720837933 |
|---|---|
| Provider Enumeration Date | 05/18/2024 |
| Last Update Date | 05/18/2024 |
| Certification Date | 05/18/2024 |
| Medicare PECOS PAC ID | 7517402159 |
|---|---|
| Medicare Enrollment ID | O20240708003899 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720837933 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Tiffiny Overath |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043919483 PECOS PAC ID: 4082087143 Enrollment ID: I20230310001656 |
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