PUTNAM COUNTY ALCOHOL & DRUG COUNCIL, INC. (NPI# 1023013729) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023013729 |
| Entity Type | Organization |
| Organization Name | PUTNAM COUNTY ALCOHOL & DRUG COUNCIL, INC. |
| Other Organization Name | PUTNAM-ST. JOHNS BEHAVIORAL HEALTHCARE |
| Practice Address |
330 Kay Larkin Dr Palatka FL 32177-2307 |
| Practice Telephone | 3863293780 |
| Practice Fax Number | 3863851269 |
| Mailing Telephone | 3863293780 |
| Mailing Fax Number | 3863851269 |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2011-12-29 |
| Authorized Official Name | MRS. JOYCE C MILLER (CHAIRPERSON BOARD OF DIRECTORS) |
| Authorized Official Telephone | 3863254714 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 324500000X | Substance Abuse Rehabilitation Facility | 0354AD252601 | FL | Residential Treatment Facilities |
| N | 251B00000X | Case Management | Agencies | ||
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | MAGELLAN | 60023030 | 01 |
| FL | MEDICAID CARE MGMT | 758545400 | 01 |
| FL | 360349100 | 05 | |
| FL | WELLCARE | 274738 | 01 |
| FL | BC/BS | 38327 | 01 |
| FL | MEDICAID COMP. ACCESS | 760471800 | 01 |
| FL | VALUE OPTIONS | 335268 | 01 |
| Other Name | Type Code |
|---|---|
| Putnam-St. Johns Behavioral Healthcare | Doing Business As Name - Organization |
| Street Address |
330 KAY LARKIN DR |
| City | PALATKA |
| State | FL |
| Zip Code | 32177-2307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063981892 | Canisha Gillon | Nurse Practitioner | 330 Kay Larkin Dr, Palatka, FL 32177-2307 | 2018-11-22 |
| 1447749973 | Willard Theodore Brannen Jr. | Counselor | 330 Kay Larkin Dr, Palatka, FL 32177-2307 | 2018-05-10 |
| 1083117063 | Letichi Maudtres Tookes | Social Worker | 330 Kay Larkin Dr, Palatka, FL 32177-2307 | 2018-03-15 |
| 1881002863 | Laurie Hamilton | Nurse Practitioner | 330 Kay Larkin Dr, Palatka, FL 32177-2307 | 2014-07-23 |
| 1669644258 | Heather Macleod | Nurse Practitioner | 330 Kay Larkin Dr, Palatka, FL 32177-2307 | 2008-03-24 |
| 1366645129 | Brenda R Castells | Psychiatry & Neurology | 330 Kay Larkin Dr, Palatka, FL 32177-2307 | 2007-06-08 |
| 1811004427 | Theresa L Hope | Nurse Practitioner | 330 Kay Larkin Dr, Palatka, FL 32177 | 2006-08-23 |
| 1285600551 | Alice A. Stephens | Counselor | 330 Kay Larkin Dr, Palatka, FL 32177-2307 | 2006-02-27 |
| 1376522797 | Kristin H Green | Social Worker | 330 Kay Larkin Dr, Palatka, FL 32177-2307 | 2006-01-13 |
| 1881691087 | Nancy Russo | Counselor | 330 Kay Larkin Dr, Palatka, FL 32177-2307 | 2005-07-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174124176 | Charlie Douglas | Pharmacist | 1024 South State Road 19, Pharmacy, Palatka, FL 32177 | 2020-11-05 |
| 1275090359 | Carol M Kazounis | Dietitian, Registered | 2801 Kennedy Strett, Palatka, FL 32177 | 2019-02-26 |
| 1447744768 | Pulido Internal Medicine | Nurse Practitioner | 700 Zeagler Drive, Suite 1, Palatka, FL 32177 | 2018-06-20 |
| 1063922656 | Ronald Michael Wendt | Nurse Practitioner | 3703 Crill Ave, Palatka, FL 32177 | 2017-10-09 |
| 1043560212 | Leslie Ann Lewis | Massage Therapist | 325 Poinsetta Ave, Palatka, FL 32177 | 2012-09-14 |
| 1285984963 | Walgreens | Pharmacy | 719 South State Road 19, Palatka, FL 32177 | 2012-09-11 |
| 1841549235 | Audrey M Russell | Pharmacy Technician | 719 Hwy 19 South, Palatka, FL 32177 | 2012-08-31 |
| 1194023838 | Sherry D. Michael | Licensed Practical Nurse | 330 Kay Larkin Dr., Palatka, FL 32177 | 2011-03-04 |
| 1083846364 | Patricia Kowalchuk | Occupational Therapy Assistant | 6050 St.johns Ave., Suite A, Palatka, FL 32177 | 2009-08-20 |
| 1609015320 | Robin Calhoun | Occupational Therapist | 611 Zeagler Dr., Palatka, FL 32177 | 2009-02-19 |
| Find all providers in zip 32177 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073114823 | Community Behavior Care LLC | Clinic/Center | 221 Ne 164th Street, Unit 276, North Miami Beach, FL 33160 | 2020-11-06 |
| 1912508938 | Melissa Frieder, LLC | Clinic/Center | 7001 Sw 97th Ave Ste 203, Miami, FL 33173-1407 | 2020-11-05 |
| 1073114278 | Love Family Health Center Corp | Clinic/Center | 313 Palm Ave, Hialeah, FL 33010-4715 | 2020-11-04 |
| 1235730417 | Aspire Health Partners, Inc. | Clinic/Center | 4520 Oak Fair Blvd, Tampa, FL 33610-7356 | 2020-11-04 |
| 1053912469 | Loves Community Mental Health Inc | Clinic/Center | 2 Nw 30th Ave, Miami, FL 33125 | 2020-11-03 |
| 1437759032 | Loves Community Mental Health Inc | Clinic/Center | 3011 W Flagler St Unit A, Miami, FL 33135-1222 | 2020-11-01 |
| 1790385342 | New Family Wellness Center Inc | Clinic/Center | 8200 Nw 41st St Ste 200-98, Doral, FL 33166-6205 | 2020-10-31 |
| 1619577475 | Prestige Behavioral Health Center, LLC | Clinic/Center | 7318 W 20th Ave, Hialeah, FL 33016-1855 | 2020-10-29 |
| 1255931101 | Pine Grove Counseling LLC | Clinic/Center | 539 Se Van Loon Ter, Cape Coral, FL 33990-1157 | 2020-10-29 |
| 1831799766 | Mindset Mental Health Services Inc | Clinic/Center | 12485 Sw 137th Ave Ste 109, Miami, FL 33186-4215 | 2020-10-29 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on PUTNAM COUNTY ALCOHOL & DRUG COUNCIL, INC..
| 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.