| Treasure Coast Psychology, Inc. | |
|
819 Sw Federal Hwy Ste 200b Stuart FL 34994-2952 | |
| (561) 531-8356 | |
| Not Available |
| Full Name | Treasure Coast Psychology, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 819 Sw Federal Hwy Ste 200b, Stuart, Florida |
| Authorized Official Name and Position | Jimmy L Middlebrook (PRESIDENT) |
| Authorized Official Contact | 5615318356 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Treasure Coast Psychology, Inc. 819 Sw Federal Hwy Ste 200b Stuart FL 34994-2952 Ph: () - | Treasure Coast Psychology, Inc. 819 Sw Federal Hwy Ste 200b Stuart FL 34994-2952 Ph: (561) 531-8356 |
| NPI Number | 1134573512 |
|---|---|
| Provider Enumeration Date | 04/21/2016 |
| Last Update Date | 04/21/2016 |
| Medicare PECOS PAC ID | 2264722693 |
|---|---|
| Medicare Enrollment ID | O20160526000566 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134573512 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | PY 9495 (Florida) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | PY 9495 (Florida) | Secondary |
| Provider Name | Jimmy L Middlebrook |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1265896476 PECOS PAC ID: 4082904412 Enrollment ID: I20160526000808 |
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