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NPI Code Detail

MEDICARE: EC THERAPEUTIC SERVICES LLC

MEDICARE: EC THERAPEUTIC SERVICES LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1063363497
Entity Type Code : Organization
Provider Name (Legal Business Name) : EC THERAPEUTIC SERVICES LLC
Provider Business Mailing Address
First Line : 327 EDGE AVE
Second Line :
City : VALPARAISO
State : FL
Zip : 32580-1070
Country : US
Telephone Number : 850-924-8104
Fax Number :
Provider Business Practice Location Address
First Line : 2018 LEWIS TURNER BLVD STE C
Second Line :
City : FORT WALTON BEACH
State : FL
Zip : 32547-1352
Country : US
Telephone Number : 850-924-8104
Fax Number : 850-702-5972
Authorized Official
Title or Position : OWNER
Name : MEREDITH MCQUAGGE
Credential : LMHC
Telephone Number : 850-924-8104
Provider Enumeration Date : 02/03/2026
Last Update Date : 02/03/2026

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Directions to “EC THERAPEUTIC SERVICES LLC ” Practice Location

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