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3333 Clark Rd Ste 110 Sarasota FL 34231-8437 | |
| (941) 363-6004 | |
| (941) 924-7546 |
| Full Name | |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3333 Clark Rd Ste 110, Sarasota, Florida |
| Authorized Official Name and Position | Kristina Bilicki Paape (OWNER) |
| Authorized Official Contact | 9416773088 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
3333 Clark Rd Ste 110 Sarasota FL 34231-8437 Ph: (941) 363-6004 | 3333 Clark Rd Ste 110 Sarasota FL 34231-8437 Ph: (941) 363-6004 |
| NPI Number | 1407287410 |
|---|---|
| Provider Enumeration Date | 12/02/2013 |
| Last Update Date | 05/09/2023 |
| Certification Date | 01/22/2022 |
| Medicare PECOS PAC ID | 4486881471 |
|---|---|
| Medicare Enrollment ID | O20131219000618 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407287410 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | SW 5492 (Florida) | Primary |
| Provider Name | Kristina B Paape |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922363167 PECOS PAC ID: 1456580745 Enrollment ID: I20140207001071 |
| Provider Name | Colleen P Panunzio |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821080102 PECOS PAC ID: 4284077686 Enrollment ID: I20240213000361 |
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