| Youth Form, Llc | |
|
1018 Thomasville Rd Tallahassee FL 32303-8701 | |
| (850) 296-2493 | |
| Not Available |
| Full Name | Youth Form, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1018 Thomasville Rd, Tallahassee, Florida |
| Authorized Official Name and Position | Kortney Clinton (FOUNDER/CLINICAN) |
| Authorized Official Contact | 8502962493 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Youth Form, Llc Po Box 332 Lloyd FL 32337-0332 Ph: (850) 296-2493 | Youth Form, Llc 1018 Thomasville Rd Tallahassee FL 32303-8701 Ph: (850) 296-2493 |
| NPI Number | 1699528059 |
|---|---|
| Provider Enumeration Date | 04/08/2024 |
| Last Update Date | 04/08/2024 |
| Certification Date | 04/07/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699528059 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Seasons Of Life Counseling, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 319 Gaile Ave, Tallahassee, FL 32305 Phone: 850-557-7975 Fax: 833-975-0096 | |
Tallahassee Neurology Associates, P.a. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2868 Mahan Dr, Suite 5, Tallahassee, FL 32308 Phone: 850-942-7177 Fax: 850-656-9443 | |
Psychiatry Associates Of Tallahassee, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1407 M D Ln Ste A, Tallahassee, FL 32308 Phone: 850-877-0635 Fax: 850-205-0195 | |
Dna Comprehensive Therapy Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1965 Capital Cir Ne Ste 102, Tallahassee, FL 32308 Phone: 850-671-4600 | |
Renewing Minds Counseling And Consulting Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4047 Ailanthus Ct, Tallahassee, FL 32305 Phone: 850-692-9268 | |
Dr. Peter Debelius-enemark, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1407 M D Ln Ste A, Tallahassee, FL 32308 Phone: 850-877-0635 Fax: 850-205-0195 | |
Tallahassee Therapy Associates, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 109 W 4th Ave, Tallahassee, FL 32303 Phone: 850-241-5707 |