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6497 Parkland Dr Ste A Sarasota FL 34243-4097 | |
| (941) 681-8260 | |
| (941) 251-8230 |
| Full Name | |
|---|---|
| Speciality | Psychologist |
| Location | 6497 Parkland Dr Ste A, Sarasota, Florida |
| Authorized Official Name and Position | Jessica Sullivan (OWNER) |
| Authorized Official Contact | 9416818260 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
6497 Parkland Dr Ste A Sarasota FL 34243-4097 Ph: (941) 681-8260 | 6497 Parkland Dr Ste A Sarasota FL 34243-4097 Ph: (941) 681-8260 |
| NPI Number | 1891338943 |
|---|---|
| Provider Enumeration Date | 10/22/2019 |
| Last Update Date | 01/24/2024 |
| Certification Date | 09/14/2023 |
| Medicare PECOS PAC ID | 0446623151 |
|---|---|
| Medicare Enrollment ID | O20230228001860 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891338943 | NPI | - | NPPES |
| Provider Name | Matthew Duhaime |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518621564 PECOS PAC ID: 7517359219 Enrollment ID: I20220107001980 |
| Provider Name | Jessica Marie Sullivan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1336448984 PECOS PAC ID: 3173996881 Enrollment ID: I20230228001928 |
| Provider Name | Monica Jean Davis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1619582418 PECOS PAC ID: 1153779319 Enrollment ID: I20231128003006 |
| Provider Name | Iris Curry |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053645077 PECOS PAC ID: 5991153843 Enrollment ID: I20231202000782 |
| Provider Name | Amanda Merkel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1588118913 PECOS PAC ID: 1759730054 Enrollment ID: I20231212002810 |
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