Organization
CHAUTAUQUA OFFICES OF PSYCHOTHERAPY AND EVALUATION, INC.
Active
Other names
C.O.P.E. Center
Organization subpart
No
Provider details
NPI number
Authorized official
RACHEL R GILLIS LCSW BCD (CHIEF EXECUTIVE OFFICER)
(850) 892-8045
Entity
Organization
Contact information
Practice address
3686 US HIGHWAY 331 S, DEFUNIAK SPRINGS, FL 32435-8463
(850) 892-8045
(850) 892-8039
Mailing address
3686 US HIGHWAY 331 S, DEFUNIAK SPRINGS, FL 32435-8463
(850) 892-8045
(850) 892-8039
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
0166AD9145-01
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
060369400
—
FL
01
—
77467
BC/BS
FL
Enumeration date
10/03/2005
Last updated
06/16/2016
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