BAYOU WELLNESS OF NORTHWEST FLORIDA, LLC (NPI# 1841778636) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841778636 |
| Entity Type | Organization |
| Organization Name | BAYOU WELLNESS OF NORTHWEST FLORIDA, LLC |
| Other Organization Name | BAYOU WELLNESS |
| Practice Address |
69 Bay Bridge Dr Ste G Gulf Breeze FL 32561-4468 |
| Practice Telephone | 8503247912 |
| Mailing Telephone | 8503247912 |
| Enumeration Date | 2018-08-02 |
| Last Update Date | 2018-08-02 |
| Authorized Official Name | ANDREA BURKS (COUNSELOR, OWNER) |
| Authorized Official Telephone | 8503247912 |
| Authorized Official Credential | LMHC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | MH12035 | FL | Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Bayou Wellness | Other Name - Individual/Organization |
| Street Address |
69 BAY BRIDGE DR STE G |
| City | GULF BREEZE |
| State | FL |
| Zip Code | 32561-4468 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033672621 | Stephanie Slorahn Peterson | Social Worker | 69 Bay Bridge Dr Ste G, Gulf Breeze, FL 32561-4468 | 2019-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700416815 | Susan Carol Bane | Physical Therapist | 1500 Via Deluna, D6, Pensacola Beach, FL 32561 | 2020-01-17 |
| 1174027478 | Aegis Group Practice LLC | Occupational Therapist | 50 Joachim Drive, Gulf Breeze, FL 32561 | 2018-03-21 |
| 1497296081 | Gulf Coast Health System Imaging, LLC | Clinic/Center | 4033 Gulf Breeze Parkway, Gulf Breeze, FL 32561 | 2017-03-15 |
| 1265836233 | Karen Tarvid | Radiologic Technologist | 1390 Fort Pickens Road, 212, Gulf Breeze, FL 32561 | 2014-10-20 |
| 1063825990 | Thomas Ryan Mcpherson | Dentist | 41 Fairpoint Dr Ste A, Gulf Breeze, FL 32561 | 2014-06-09 |
| 1316210974 | White Edward Gibson IIi | Internal Medicine | 408 N. Sunset Blvd., Gulf Breeze, FL 32561 | 2012-02-13 |
| 1467742866 | Katherine Seipel Crawford | Pediatrics | 15 Daniel Dr, Gulf Breeze, FL 32561 | 2011-04-19 |
| 1497067987 | Total Spinal Solutions LLC | Clinic/Center | 1300 Shoreline Drive, Ste. 104, Gulf Breeze, FL 32561 | 2010-07-13 |
| 1528184322 | Bonnie Dansby | Nurse Practitioner | 1600 Via Deluna Drive, E403, Pensacola Beach, FL 32561 | 2007-03-22 |
| 1891841425 | Darby Lynn Godwin | Psychologist | 7 Center Road, Gulf Breeze, FL 32561 | 2007-01-26 |
| Find all providers in zip 32561 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| 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. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649795469 | Elizabeth Marie O'connor | Counselor | 913 Gulf Breeze Pkwy Ste 26, Gulf Breeze, FL 32561-4731 | 2017-08-14 |
| 1346638376 | Yvette Wirt | Counselor | 5539 Soundside Dr Apt L, Gulf Breeze, FL 32563-9528 | 2014-12-29 |
| 1700180619 | Amy Armstrong | Counselor | 418 Warwick St, Gulf Breeze, FL 32561-4153 | 2011-01-06 |
| 1750507430 | Katherine G Randall | Counselor | 3880 Paradise Bay Dr, Gulf Breeze, FL 32563-5905 | 2007-04-18 |
| 1720198823 | Tracy Glaze | Counselor | 1198 Gulf Breeze Pkway, Suite 4, Gulf Breeze, FL 32561 | 2006-08-30 |
| 1508491762 | Wild Thistle Therapy LLC | Counselor | 2990 Gulf Breeze Pkwy, Gulf Breeze, FL 32563-3100 | 2020-03-09 |
| 1720488265 | Samantha Denegri | Counselor | 3208 Gulf Breeze Pkwy, Gulf Breeze, FL 32563-3350 | 2014-09-03 |
| 1619267929 | Jessica Sue Koziara | Counselor | 293 Plantation Hill Rd, Gulf Breeze, FL 32561-4861 | 2011-04-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710588322 | Rebecca Ann Heald | Counselor | 2430 Duncan Dr, Niceville, FL 32578-2916 | 2020-11-02 |
| 1598366171 | Neurodiverse Ability Services LLC | Counselor | 608 Sw Marvin Burnett Rd, Lake City, FL 32025-4918 | 2020-11-02 |
| 1316547839 | Amber Kovach | Counselor | 8290 Matisse St, Champions Gate, FL 33896-8334 | 2020-10-26 |
| 1760081202 | Nih Holdings LLC | Counselor | 7711 N Military Trl Ste 1014, West Palm Beach, FL 33410-6506 | 2020-10-24 |
| 1346849072 | Blanca Rodriguez | Counselor | 1201 Lavender Jewel Ct, Plant City, FL 33563-2515 | 2020-10-23 |
| 1235738063 | Selena Giordano | Counselor | 1001 East Baker Street #100, Plant City, FL 33563 | 2020-10-22 |
| 1306444989 | Robert A Fahey | Counselor | 3927 Vine Tree Trl Apt A, Lake Worth, FL 33467-8540 | 2020-10-15 |
| 1952909178 | Elizabeth Leon | Counselor | 1067 Nw 119th St, North Miami, FL 33168-6240 | 2020-10-09 |
| 1518564301 | Lisa Chhabra | Counselor | 504 Pelican Ln N, Jupiter, FL 33458-8365 | 2020-10-05 |
| 1124635081 | Always Behavioral Counseling Services | Counselor | 5724 Byron Anthony Pl Apt 338, Sanford, FL 32771-8633 | 2020-09-24 |
| Find all providers with the same taxonomy | ||||
| City | GULF BREEZE |
| Zip Code | 32561 |
Please comment or provide details below to improve the information on BAYOU WELLNESS OF NORTHWEST FLORIDA, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.