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| |
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1090 S Tamiami Trl Sarasota FL 34236-9116 | |
| (941) 363-0878 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychologist |
| Location | 1090 S Tamiami Trl, Sarasota, Florida |
| Authorized Official Name and Position | Virginia Marie Steelman (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 7045066267 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
11000 Optum Cir Eden Prairie MN 55344-2503 Ph: (704) 506-6267 | 1090 S Tamiami Trl Sarasota FL 34236-9116 Ph: (941) 363-0878 |
| NPI Number | 1033984448 |
|---|---|
| Provider Enumeration Date | 11/16/2023 |
| Last Update Date | 11/16/2023 |
| Certification Date | 11/16/2023 |
| Medicare PECOS PAC ID | 5092120030 |
|---|---|
| Medicare Enrollment ID | O20240401000110 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033984448 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | (* (Not Available)) | Primary |
| Provider Name | Robert L Stephenson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1023001716 PECOS PAC ID: 6204897937 Enrollment ID: I20041025001200 |
| Provider Name | Kenton J Kauffman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598750044 PECOS PAC ID: 4981667029 Enrollment ID: I20041109000851 |
| Provider Name | Jacqueline D Boutrouille |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447295886 PECOS PAC ID: 2466479910 Enrollment ID: I20051025000241 |
| Provider Name | Elizabeth A Handte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144293168 PECOS PAC ID: 3476572413 Enrollment ID: I20051118000182 |
| Provider Name | Maryla I Madura |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841340809 PECOS PAC ID: 9133287451 Enrollment ID: I20081015000230 |
| Provider Name | Dale G Simpson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194779470 PECOS PAC ID: 0648459321 Enrollment ID: I20110202000534 |
| Provider Name | Wendy Dawn Sims |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1861798589 PECOS PAC ID: 3173705969 Enrollment ID: I20110316000151 |
| Provider Name | Martha Otice |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285794651 PECOS PAC ID: 2062303035 Enrollment ID: I20110330000815 |
| Provider Name | Jody A Kaufman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013935287 PECOS PAC ID: 2062698145 Enrollment ID: I20110526000022 |
| Provider Name | Tiffany Schiffner |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316228950 PECOS PAC ID: 9931369113 Enrollment ID: I20120326000523 |
| Provider Name | Kinshuk Bose |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598925497 PECOS PAC ID: 7517116700 Enrollment ID: I20121003000516 |
| Provider Name | Angela Gibson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013089531 PECOS PAC ID: 7214974641 Enrollment ID: I20121008000397 |
| Provider Name | Mary Morel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669544185 PECOS PAC ID: 5496792822 Enrollment ID: I20121008000410 |
| Provider Name | Douglas J Kovatch |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588759419 PECOS PAC ID: 0547362782 Enrollment ID: I20130709000430 |
| Provider Name | Steven J Steiner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255365169 PECOS PAC ID: 5698915932 Enrollment ID: I20130709000527 |
| Provider Name | Cindy Karen Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073847075 PECOS PAC ID: 6709017775 Enrollment ID: I20140317001181 |
| Provider Name | Kyle Cieply |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1548592199 PECOS PAC ID: 3577692821 Enrollment ID: I20140709000306 |
| Provider Name | Adrian Brian Blotner |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184616948 PECOS PAC ID: 7315961562 Enrollment ID: I20140806000837 |
| Provider Name | Jerrod K Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1780928556 PECOS PAC ID: 4082930938 Enrollment ID: I20150311002367 |
| Provider Name | Sabrina Caceres |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457511263 PECOS PAC ID: 4183941719 Enrollment ID: I20150319001836 |
| Provider Name | Justin M Simpson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1407153471 PECOS PAC ID: 3476724303 Enrollment ID: I20170202000651 |
| Provider Name | Michelle Rodriguez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346694734 PECOS PAC ID: 6305122177 Enrollment ID: I20170410001121 |
| Provider Name | Marie L Trgovac |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831637685 PECOS PAC ID: 2769768530 Enrollment ID: I20170410001208 |
| Provider Name | Michael H Leblond |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063710952 PECOS PAC ID: 0749422574 Enrollment ID: I20170425001879 |
| Provider Name | Justin Forrest Dement |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285149823 PECOS PAC ID: 8224397104 Enrollment ID: I20180123000576 |
| Provider Name | Scott A Eader |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336178433 PECOS PAC ID: 0244505154 Enrollment ID: I20180131001344 |
| Provider Name | Carrie Ann Hood Strong |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1114977592 PECOS PAC ID: 8325191992 Enrollment ID: I20180419002494 |
| Provider Name | Timothy D Rogers |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760799548 PECOS PAC ID: 0941563142 Enrollment ID: I20180423001909 |
| Provider Name | James J Meeks |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740608983 PECOS PAC ID: 5496064594 Enrollment ID: I20180525001804 |
| Provider Name | Evie L Breedlove |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194132233 PECOS PAC ID: 2062639719 Enrollment ID: I20180711000721 |
| Provider Name | Martin J Desantis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902091036 PECOS PAC ID: 0042480352 Enrollment ID: I20180724002684 |
| Provider Name | Yadira Nogueras-rosado |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962829853 PECOS PAC ID: 8628313830 Enrollment ID: I20181217001448 |
| Provider Name | Sha'leda Mirra |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780015214 PECOS PAC ID: 4385984723 Enrollment ID: I20190320003134 |
| Provider Name | Vanderbilt W Robison |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972950491 PECOS PAC ID: 8921348392 Enrollment ID: I20190321000592 |
| Provider Name | Debbie L Gross |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043646995 PECOS PAC ID: 5991095929 Enrollment ID: I20190506000588 |
| Provider Name | Leslie Fraser |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1710375134 PECOS PAC ID: 2668708041 Enrollment ID: I20190723001752 |
| Provider Name | Kayla Jane Davidson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245898352 PECOS PAC ID: 2365779063 Enrollment ID: I20190802001475 |
| Provider Name | Lorelle Destefano |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194185165 PECOS PAC ID: 0749574978 Enrollment ID: I20191218000142 |
| Provider Name | Cynthia Carnes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326670167 PECOS PAC ID: 1254769227 Enrollment ID: I20200325002887 |
| Provider Name | Meriam Mikhail |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063061257 PECOS PAC ID: 5496186827 Enrollment ID: I20200519000471 |
| Provider Name | Cheryl M. Wong |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598722183 PECOS PAC ID: 6608207915 Enrollment ID: I20200520001081 |
| Provider Name | Nicole Marie Micucci |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992252878 PECOS PAC ID: 5799106498 Enrollment ID: I20200604003187 |
| Provider Name | Justin Conrad Koenitzer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1578824421 PECOS PAC ID: 2567880321 Enrollment ID: I20200911000515 |
| Provider Name | Lisa Ann Mansell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669090890 PECOS PAC ID: 0547680241 Enrollment ID: I20201019002669 |
| Provider Name | Tamara A Spratley |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1174535702 PECOS PAC ID: 3173587789 Enrollment ID: I20210305001024 |
| Provider Name | Veronica C Montgomery |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346883121 PECOS PAC ID: 1355757964 Enrollment ID: I20210305001588 |
| Provider Name | Deanne Elizabeth Grayson |
|---|---|
| Provider Type | Practitioner - Geriatric Psychiatry |
| Provider Identifiers | NPI Number: 1851685135 PECOS PAC ID: 5991037293 Enrollment ID: I20210319001382 |
| Provider Name | Joshua Lotfallah |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114272184 PECOS PAC ID: 4284865932 Enrollment ID: I20210427000290 |
| Provider Name | Amanda Colon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114491123 PECOS PAC ID: 0143629626 Enrollment ID: I20210603001743 |
| Provider Name | Marjorie Capers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497203210 PECOS PAC ID: 0143509109 Enrollment ID: I20210805001855 |
| Provider Name | Maria Lana Barnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871128363 PECOS PAC ID: 8729485891 Enrollment ID: I20210916002750 |
| Provider Name | Julie B. Riley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568138030 PECOS PAC ID: 2466850912 Enrollment ID: I20211013002262 |
| Provider Name | Angela A Priester |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1144252545 PECOS PAC ID: 3678513207 Enrollment ID: I20211027001692 |
| Provider Name | Yuliya Caprietta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124555628 PECOS PAC ID: 9931460227 Enrollment ID: I20211119000543 |
| Provider Name | Ana U Chipollini |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346753472 PECOS PAC ID: 5698102200 Enrollment ID: I20211201001948 |
| Provider Name | Ashley Nicole Hall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477219699 PECOS PAC ID: 3779974068 Enrollment ID: I20211221001309 |
| Provider Name | Stephanie Smith |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093262768 PECOS PAC ID: 1254612740 Enrollment ID: I20220110002284 |
| Provider Name | Vanesa Disla De Jesus |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1275982274 PECOS PAC ID: 0143653550 Enrollment ID: I20220824000391 |
| Provider Name | Sara Elizabeth Marchon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215236492 PECOS PAC ID: 6901154129 Enrollment ID: I20220831003677 |
| Provider Name | Paul Lobianco |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508919564 PECOS PAC ID: 3870624943 Enrollment ID: I20220906000287 |
| Provider Name | Mary Beth Russo Blackwell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063731263 PECOS PAC ID: 8224359203 Enrollment ID: I20221115000356 |
| Provider Name | Anem Javed Nawaz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356831267 PECOS PAC ID: 8820341373 Enrollment ID: I20221117000139 |
| Provider Name | Lydia Olson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861100505 PECOS PAC ID: 5597135632 Enrollment ID: I20230105001553 |
| Provider Name | Melinda D Collins |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558326132 PECOS PAC ID: 0749288512 Enrollment ID: I20230314003185 |
| Provider Name | Megan E Crowningshield |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699402750 PECOS PAC ID: 0941674733 Enrollment ID: I20230317001086 |
| Provider Name | Steven Carlsson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124730825 PECOS PAC ID: 8527424613 Enrollment ID: I20230516000521 |
| Provider Name | Elizabeth Michelle Deaton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831890763 PECOS PAC ID: 5890151419 Enrollment ID: I20230523002741 |
| Provider Name | Ryan Matthew Ware |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083112478 PECOS PAC ID: 7517390115 Enrollment ID: I20230602000356 |
| Provider Name | John Noteware |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922305069 PECOS PAC ID: 0345557765 Enrollment ID: I20230606002045 |
| Provider Name | Nadine R Greene |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629647979 PECOS PAC ID: 4587025127 Enrollment ID: I20230731001095 |
| Provider Name | Marcia Elyse Youngerman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851611610 PECOS PAC ID: 6800259557 Enrollment ID: I20230828002859 |
| Provider Name | Dominique Simone Reyes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447899703 PECOS PAC ID: 5294198438 Enrollment ID: I20230905004117 |
| Provider Name | Geoffrey Tremont |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1043297880 PECOS PAC ID: 6800929530 Enrollment ID: I20230911004292 |
| Provider Name | Susan Lee Folker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558675629 PECOS PAC ID: 8325497886 Enrollment ID: I20231208001233 |
| Provider Name | Matthew Darin Federici |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790256501 PECOS PAC ID: 0042669558 Enrollment ID: I20231209000107 |
| Provider Name | Michelle Murray Craun |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1528510047 PECOS PAC ID: 4587013933 Enrollment ID: I20231211000635 |
| Provider Name | John Martin Whitaker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770843195 PECOS PAC ID: 4183073331 Enrollment ID: I20231213000675 |
| Provider Name | Jonathan Valletta |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376071910 PECOS PAC ID: 8921457193 Enrollment ID: I20231213001487 |
| Provider Name | David Umbras |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558758136 PECOS PAC ID: 3173972205 Enrollment ID: I20231214000057 |
| Provider Name | Patricia Jo Musselwhite-weaver |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1023080496 PECOS PAC ID: 3173973575 Enrollment ID: I20231227003012 |
| Provider Name | Randy Warner |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144380056 PECOS PAC ID: 5294712279 Enrollment ID: I20240129004608 |
| Provider Name | Christine Lynn Parisen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598261810 PECOS PAC ID: 1355786708 Enrollment ID: I20240226002439 |
| Provider Name | Dolores Aida Flores |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932317310 PECOS PAC ID: 5991140675 Enrollment ID: I20240304003814 |
| Provider Name | Nishan Warren |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932660727 PECOS PAC ID: 1557709599 Enrollment ID: I20240409004535 |
| Provider Name | Karen Dixon Hathcock |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710251301 PECOS PAC ID: 5597106153 Enrollment ID: I20240514001081 |
| Provider Name | Arielle Theodore |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841911740 PECOS PAC ID: 7214378652 Enrollment ID: I20240515004378 |
| Provider Name | Kaydianne Nugent-jackson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568038826 PECOS PAC ID: 2769823038 Enrollment ID: I20240517000498 |
| Provider Name | Stephonia Kamika Llewellyn |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720565203 PECOS PAC ID: 6507207800 Enrollment ID: I20240517001712 |
| Provider Name | Elizabeth Brodowsky |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922550904 PECOS PAC ID: 5698117844 Enrollment ID: I20240521000079 |
| Provider Name | Kemley Jean |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184278236 PECOS PAC ID: 6305288473 Enrollment ID: I20240522000216 |
| Provider Name | Stephanie Safos-moriarty |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942606066 PECOS PAC ID: 9739521360 Enrollment ID: I20240528001751 |
| Provider Name | Angelica Maria Ventresca |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255759643 PECOS PAC ID: 7113469412 Enrollment ID: I20240601000378 |
| Provider Name | Carolee Ann Linder |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1255756607 PECOS PAC ID: 1153864467 Enrollment ID: I20240614002133 |
| Provider Name | Patrick Mccawley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285372425 PECOS PAC ID: 5395282032 Enrollment ID: I20240731000852 |
| Provider Name | Michael Lee Haney |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154895456 PECOS PAC ID: 3072050749 Enrollment ID: I20240731002021 |
| Provider Name | Kathryn Bliss |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295748556 PECOS PAC ID: 9830636257 Enrollment ID: I20240802003065 |
| Provider Name | Ashley A Busch |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669840153 PECOS PAC ID: 8022555465 Enrollment ID: I20240803000102 |
| Provider Name | Diana Marie Tafur |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265090781 PECOS PAC ID: 1759820608 Enrollment ID: I20240823001428 |
| Provider Name | Laura Marie Cowart |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154791002 PECOS PAC ID: 3274072822 Enrollment ID: I20240827001839 |
| Provider Name | Ann Marie Makowski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063190122 PECOS PAC ID: 8729527346 Enrollment ID: I20240827004678 |
| Provider Name | Nicole V Schreiber |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1679874044 PECOS PAC ID: 8628517158 Enrollment ID: I20240828004701 |
| Provider Name | Kasie Wallace |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477063410 PECOS PAC ID: 8022557263 Enrollment ID: I20240830003744 |
| Provider Name | Marlene Lucia Larose |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1013256270 PECOS PAC ID: 2466991658 Enrollment ID: I20240903000455 |
| Provider Name | Gloria M Gonzalez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306077730 PECOS PAC ID: 3678733847 Enrollment ID: I20240911004514 |
| Provider Name | David Y Grimm |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1609849405 PECOS PAC ID: 0648701763 Enrollment ID: I20241001000432 |
| Provider Name | Angela C Bushell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356623870 PECOS PAC ID: 8921539982 Enrollment ID: I20241001002336 |
| Provider Name | Marly Ayala-icaza |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821412230 PECOS PAC ID: 5890227755 Enrollment ID: I20241016002626 |
| Provider Name | Crystal Dawn Hicks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285208603 PECOS PAC ID: 5395277107 Enrollment ID: I20241017004195 |
Bluestone Psychiatry, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5664 Bee Ridge Rd Ste 203, Sarasota, FL 34233 Phone: 877-422-9355 Fax: 877-422-9355 | |
Suncoast Therapy, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5224 Station Way, Sarasota, FL 34233 Phone: 941-485-0121 Fax: 941-485-0519 | |
Robert K Winegar Psy D Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1991 Hyde Park St, Sarasota, FL 34239 Phone: 941-953-4313 Fax: 941-954-8631 | |
Marilyn Pearlman Pa Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3293 Fruitville Rd Unit 103, Sarasota, FL 34237 Phone: 941-366-4411 Fax: 941-366-4641 | |
Restore Marriage And Family Therapy, L.l.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1491 2nd St Ste D, Sarasota, FL 34236 Phone: 631-356-3367 | |
Centerpointe Counseling And Recovery Of Sarasota Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5632 Bee Ridge Rd, Unit101, Sarasota, FL 34233 Phone: 941-488-4811 Fax: 941-488-4899 |