MEDICARE: PENSACOLA COUNSELING, 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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1932667730
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PENSACOLA COUNSELING, LLC

Provider Business Mailing Address
First Line	:	1720 W FAIRFIELD DR STE 303
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32501-1057
Country	:	US
Telephone Number	:	850-341-0683
Fax Number	:

Provider Business Practice Location Address
First Line	:	1720 W FAIRFIELD DR STE 303
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32501-1057
Country	:	US
Telephone Number	:	850-341-0683
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. MORGAN ANGEL
Credential	:	LMHC
Telephone Number	:	850-341-0683

Provider Enumeration Date	:	03/11/2019
Last Update Date	:	03/11/2019

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