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BAYOU WELLNESS OF NORTHWEST FLORIDA LLC NPI 1841778636


NPI Information

NPI: 1841778636
Provider Name: BAYOU WELLNESS OF NORTHWEST FLORIDA, LLC

Other Name: BAYOU WELLNESS

Classification: Counselor - 101Y00000X
Entity Type: Organization
Address:
69 BAY BRIDGE DR STE G
GULF BREEZE, FL
ZIP 32561
Phone: (850) 324-7912
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BAYOU WELLNESS OF NORTHWEST FLORIDA, LLC is a counselor in Gulf Breeze, FL. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. BAYOU WELLNESS OF NORTHWEST FLORIDA, LLC NPI is 1841778636. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Bayou Wellness.

The provider's business location address is:

69 BAY BRIDGE DR STE G
GULF BREEZE, FL
ZIP 32561-468
Phone: (850) 324-7912

The provider's authorized official is Andrea Burks .
The authorized official title is Counselor, Owner and has the following contact phone number (850) 324-7912.

The enumeration date for this NPI number is 8/2/2018 and was last updated on 8/2/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101Y00000XCounselorMH12035FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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