| Jewish Family & Childrens Service Of The Suncoast Inc | |
|
2688 Fruitville Road Sarasota FL 34237 | |
| (941) 366-2224 | |
| (941) 366-2982 |
| Full Name | Jewish Family & Childrens Service Of The Suncoast Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2688 Fruitville Road, Sarasota, Florida |
| Authorized Official Name and Position | Stephen Michael Musco (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 9413662224 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jewish Family & Childrens Service Of The Suncoast Inc 2688 Fruitville Road Sarasota FL 34237 Ph: (941) 366-2224 | Jewish Family & Childrens Service Of The Suncoast Inc 2688 Fruitville Road Sarasota FL 34237 Ph: (941) 366-2224 |
| NPI Number | 1457383861 |
|---|---|
| Provider Enumeration Date | 07/07/2006 |
| Last Update Date | 01/14/2019 |
| Medicare PECOS PAC ID | 4587643168 |
|---|---|
| Medicare Enrollment ID | O20040716000820 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457383861 | NPI | - | NPPES |
| 001870500 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Carolyn S Stephens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942234844 PECOS PAC ID: 8628079894 Enrollment ID: I20070131000232 |
| Provider Name | Robert K Boxley |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1871584045 PECOS PAC ID: 3577747880 Enrollment ID: I20110412000226 |
| Provider Name | Karen A Lord |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023415114 PECOS PAC ID: 8426373325 Enrollment ID: I20150219000915 |
| Provider Name | Judith E Wiggins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730375338 PECOS PAC ID: 3577860303 Enrollment ID: I20160322002571 |
| Provider Name | Douglas M Rubano |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104126705 PECOS PAC ID: 2264713403 Enrollment ID: I20170103000548 |
| Provider Name | Katherine Bernal |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174038012 PECOS PAC ID: 7618238254 Enrollment ID: I20180223000079 |
| Provider Name | Claudia L Iantorno |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861468126 PECOS PAC ID: 8628249919 Enrollment ID: I20181126000711 |
| Provider Name | Sarah Elise Cooper |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326569096 PECOS PAC ID: 9739425299 Enrollment ID: I20190104001211 |
| Provider Name | Maralilian M Cunha |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154082949 PECOS PAC ID: 0446632848 Enrollment ID: I20220802001221 |
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