Provider Demographics
| NPI: | 1477651669 |
|---|---|
| Name: | HEALTH PLANNING COUNCIL OF SOUTHWEST FLORIDA, INC |
| Entity Type: | Organization |
| Organization Name: | HEALTH PLANNING COUNCIL OF SOUTHWEST FLORIDA, INC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | DATA ANALYST |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | ANNA |
| Authorized Official - Middle Name: | MARIE |
| Authorized Official - Last Name: | PEDRAZA |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 239-433-6700 |
| Mailing Address - Street 1: | 8961 DANIELS CENTER DR |
| Mailing Address - Street 2: | SUITE 401 |
| Mailing Address - City: | FORT MYERS |
| Mailing Address - State: | FL |
| Mailing Address - Zip Code: | 33912-0314 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 239-433-6700 |
| Mailing Address - Fax: | 239-433-6706 |
| Practice Address - Street 1: | 8961 DANIELS CENTER DR |
| Practice Address - Street 2: | SUITE 401 |
| Practice Address - City: | FORT MYERS |
| Practice Address - State: | FL |
| Practice Address - Zip Code: | 33912-0314 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 239-433-6700 |
| Practice Address - Fax: | 239-433-6705 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2006-09-20 |
| Last Update Date: | 2022-03-03 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| 103K00000X, 104100000X, 171M00000X, 172V00000X, 174H00000X, 222Q00000X, 2355S0801X, 235Z00000X, 251B00000X, 251C00000X, 251K00000X, 251S00000X, 252Y00000X, 253Z00000X | ||
| FL | 252Y00000X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 252Y00000X | Agencies | Early Intervention Provider Agency | Group - Multi-Specialty | |
| No | 103K00000X | Behavioral Health & Social Service Providers | Behavior Analyst | Group - Multi-Specialty | |
| No | 104100000X | Behavioral Health & Social Service Providers | Social Worker | Group - Multi-Specialty | |
| No | 171M00000X | Other Service Providers | Case Manager/Care Coordinator | Group - Multi-Specialty | |
| No | 172V00000X | Other Service Providers | Community Health Worker | Group - Multi-Specialty | |
| No | 174H00000X | Other Service Providers | Health Educator | Group - Multi-Specialty | |
| No | 222Q00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Developmental Therapist | Group - Multi-Specialty | |
| No | 2355S0801X | Speech, Language and Hearing Service Providers | Specialist/Technologist | Speech-Language Assistant | Group - Multi-Specialty |
| No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty | |
| No | 251B00000X | Agencies | Case Management | Group - Multi-Specialty | |
| No | 251C00000X | Agencies | Day Training, Developmentally Disabled Services | Group - Multi-Specialty | |
| No | 251K00000X | Agencies | Public Health or Welfare | Group - Multi-Specialty | |
| No | 251S00000X | Agencies | Community/Behavioral Health | ||
| No | 253Z00000X | Agencies | In Home Supportive Care |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| FL | 890692100 | Medicaid | |
| FL | Y930N | Other | BCBS OF FLORIDA |
| FL | 910908100 | Medicaid | |
| FL | 811219300 | Medicaid |
