MEDICARE: HEUSNER SOCIAL SOLUTIONS, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	103K00000X	Behavior Analyst
3	103T00000X	Psychologist
4	106H00000X	Marriage & Family Therapist
5	163WP0808X	Psychiatric/Mental Health Registered Nurse
6	171M00000X	Case Manager/Care Coordinator
7	2084P0800X	Psychiatry Physician
8	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
9	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1164260972
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEUSNER SOCIAL SOLUTIONS, LLC

Provider Business Mailing Address
First Line	:	1921 MENDOCINO LN
Second Line	:
City	:	PORT ORANGE
State	:	FL
Zip	:	32128-7408
Country	:	US
Telephone Number	:	407-494-5511
Fax Number	:

Provider Business Practice Location Address
First Line	:	1615 RIDGEWOOD AVE STE B
Second Line	:
City	:	HOLLY HILL
State	:	FL
Zip	:	32117-1798
Country	:	US
Telephone Number	:	386-999-0333
Fax Number	:

Authorized Official
Title or Position	:	CHIEF CLINICAL DIRECTOR
Name	:	NADINE HEUSNER
Credential	:	LCSW
Telephone Number	:	407-494-5511

Provider Enumeration Date	:	07/16/2024
Last Update Date	:	07/16/2024

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Directions to “HEUSNER SOCIAL SOLUTIONS, LLC ” Practice Location

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