| Beacon Clinic, Inc. | |
|
3821 Tamiami Trl # D Port Charlotte FL 33952-8377 | |
| (941) 629-7855 | |
| (941) 629-9589 |
| Full Name | Beacon Clinic, Inc. |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 3821 Tamiami Trl # D, Port Charlotte, Florida |
| Authorized Official Name and Position | Noel E Holdsworth (DIRECTOR) |
| Authorized Official Contact | 9416297855 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Beacon Clinic, Inc. 3821 Tamiami Trl # D Port Charlotte FL 33952-8377 Ph: (941) 629-7855 | Beacon Clinic, Inc. 3821 Tamiami Trl # D Port Charlotte FL 33952-8377 Ph: (941) 629-7855 |
| NPI Number | 1194803734 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194803734 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | NP2596452 (Florida) | Primary |
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