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Individual

DR. JERRY L. OESTMANN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
136 JULIA ST UNIT 100, NEW SMYRNA BEACH, FL 32168-7713
(386) 423-9162
(386) 423-3094
Mailing address
1730 DUNLAWTON AVE, SUITE 3, PORT ORANGE, FL 32127-8985
(386) 957-3905
(386) 402-8992

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
396
NE
101YP2500X
Professional Counselor
188
NE
103T00000X
Psychologist
620
NE
103T00000X
Psychologist
Primary
PY9026
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
098935
MEDICARE FSI PTAN GROUP NUMBER
NE
05
10025208000
NE
05
10025208600
NE
05
10025208700
NE
05
1002550710
NE
05
10025668200
NE
01
250307
MIDLANDS INS
NE
01
345680000
MAGELLAN MIS ADOL GT
NE
01
349507000
MAGELLAN MIS WOMEN'S GT
NE
05
47052851500
NE
05
47052851502
NE
05
47052851503
NE
05
47052851504
NE
05
47052851509
NE
05
47052851581
NE
05
47075636930
NE
05
47075636998
NE
01
68505B002
TRICARE
NE
01
80023
BLUE CROSS & BLUE SHIELD
NE
01
81118
BCBS INDIVIDUAL PROVIDER NUMBER
NE
01
85731
BCBS
NE
Enumeration date
11/16/2006
Last updated
10/17/2025
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