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2477 Stickney Point Rd Ste 115b Sarasota FL 34231-4092 | |
| (941) 780-1569 | |
| (941) 922-7515 |
| Full Name | |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 2477 Stickney Point Rd Ste 115b, Sarasota, Florida |
| Authorized Official Name and Position | Lisa A Jennay (LMFT) |
| Authorized Official Contact | 9417801569 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
2477 Stickney Point Rd Ste 115b Sarasota FL 34231-4092 Ph: (941) 780-1569 | 2477 Stickney Point Rd Ste 115b Sarasota FL 34231-4092 Ph: (941) 780-1569 |
| NPI Number | 1366069916 |
|---|---|
| Provider Enumeration Date | 06/30/2020 |
| Last Update Date | 02/22/2024 |
| Certification Date | 02/22/2024 |
| Medicare PECOS PAC ID | 8123471505 |
|---|---|
| Medicare Enrollment ID | O20240201002349 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366069916 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Lisa A Jennay |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1033203864 PECOS PAC ID: 0941653323 Enrollment ID: I20240222003556 |
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