Washington County Council on Aging, Inc.

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

WASHINGTON COUNTY COUNCIL ON AGING, INC.

Practice address

1348 South Blvd
Chipley, FL 32428-1846

Phone

(850) 638-6217

Fax

(850) 638-6363

NPI assigned

Jun 26, 2007

Last updated

Apr 28, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tracey Long

Title

Executive Director

Phone

(850) 638-6217

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682640000000",
    "number": "1629274659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1348 SOUTH BLVD",
            "city": "CHIPLEY",
            "state": "FL",
            "postal_code": "324281846",
            "telephone_number": "850-638-6217",
            "fax_number": "850-638-6363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1348 SOUTH BLVD",
            "city": "CHIPLEY",
            "state": "FL",
            "postal_code": "324281846",
            "telephone_number": "850-638-6217",
            "fax_number": "850-638-6363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON COUNTY COUNCIL ON AGING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-26",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "850-638-6217"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024869000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Colleen Wahl, ARNP, DNP
• Wal-Mart Stores East LP (Walmart Pharmacy 10-2114)
• Wal-Mart Stores East, LP (Vision Center 30-2114)
• Samuel Edward Ward, MD
• Washington County Ambulance
• Washington County School Board
• Washington County Schools
• Washington County Schools
• Washington County Schools
• Washington Opco LLC

• In Home Supportive Care Agency in Chipley, FL
• Providers in Chipley, FL by specialty
• In Home Supportive Care Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.