MEDICARE: THERAPY TREE TO LIFE 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
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1518776574
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THERAPY TREE TO LIFE LLC

Provider Business Mailing Address
First Line	:	9471 PARKER PLACE DR
Second Line	:
City	:	NAVARRE
State	:	FL
Zip	:	32566-2864
Country	:	US
Telephone Number	:	404-397-4567
Fax Number	:

Provider Business Practice Location Address
First Line	:	217 MIRACLE STRIP PKWY SE
Second Line	:
City	:	FORT WALTON BEACH
State	:	FL
Zip	:	32548-5819
Country	:	US
Telephone Number	:	850-992-7753
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	PASCHA AVERY
Credential	:
Telephone Number	:	404-397-4567

Provider Enumeration Date	:	01/04/2025
Last Update Date	:	01/04/2025

Similar Medicare Providers

1114456175 — EBONYE JUNAE DICKENS LMHC
Practice Location Address:

217 MIRACLE STRIP PKWY SE STE 121
FORT WALTON BEACH, FL
32548-5819

Practice Phone: 850-966-3030
Practice Fax: 850-563-9100

1801536917 — BIGG COUNSELING & CONSULTING, INC.
Practice Location Address:

217 MIRACLE STRIP PKWY SE STE 121
FORT WALTON BEACH, FL
32548-5819

Practice Phone: 850-861-7171
Practice Fax: 850-563-9100

1386408177 — MRS. MARY ANNE EVERTZ WILCOX
Practice Location Address:

217 MIRACLE STRIP PKWY SE
FORT WALTON BEACH, FL
32548-5819

Practice Phone: 850-861-7171
Practice Fax:

1851157945 — MEGAN ELLIS
Practice Location Address:

217 MIRACLE STRIP PKWY SE STE 121
FORT WALTON BEACH, FL
32548-5819

Practice Phone: 850-861-7171
Practice Fax:

1215820105 — STACI BEHM RN, BSN
Practice Location Address:

217 MIRACLE STRIP PKWY SE STE 104
FORT WALTON BEACH, FL
32548-5819

Practice Phone: 850-376-3197
Practice Fax:

1205562527 — ESTELLE GERTRUDE HARRIS NEUFVILLE LCSW
Practice Location Address:

2609 JANICE LN
FORT WORTH, TX
76112-5819

Practice Phone: 817-798-7104
Practice Fax:

Directions to “THERAPY TREE TO LIFE LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.