| Refresh Canopy Cove Inc. | |
|
1090 S Tamiami Trl Sarasota FL 34236 | |
| (941) 363-0878 | |
| Not Available |
| Full Name | Refresh Canopy Cove Inc. |
|---|---|
| Speciality | Psychiatric Residential Treatment Facility |
| Location | 1090 S Tamiami Trl, Sarasota, Florida |
| Authorized Official Name and Position | Elisabeth Pesce (SECRETARY) |
| Authorized Official Contact | 9046054986 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Refresh Canopy Cove Inc. 1090 S Tamiami Trl Sarasota FL 34236-9116 Ph: () - | Refresh Canopy Cove Inc. 1090 S Tamiami Trl Sarasota FL 34236 Ph: (941) 363-0878 |
| NPI Number | 1730661752 |
|---|---|
| Provider Enumeration Date | 09/06/2018 |
| Last Update Date | 03/30/2023 |
| Certification Date | 03/30/2023 |
| Medicare PECOS PAC ID | 3779822119 |
|---|---|
| Medicare Enrollment ID | O20190304000354 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730661752 | NPI | - | NPPES |
| Provider Name | Jill T Schechter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740275544 PECOS PAC ID: 4385532753 Enrollment ID: I20040308000678 |
| Provider Name | Guido Nodal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427064435 PECOS PAC ID: 7911999404 Enrollment ID: I20040402000684 |
| 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 | Manuel Mota Castillo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003867698 PECOS PAC ID: 9133179567 Enrollment ID: I20050124001045 |
| Provider Name | Diane K Brantley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366451874 PECOS PAC ID: 8123043288 Enrollment ID: I20051008000016 |
| Provider Name | Jacqueline D Boutrouille |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447295886 PECOS PAC ID: 2466479910 Enrollment ID: I20051025000241 |
| Provider Name | Emanuel Martinez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548264518 PECOS PAC ID: 1153348313 Enrollment ID: I20051027000043 |
| Provider Name | Elizabeth A Handte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144293168 PECOS PAC ID: 3476572413 Enrollment ID: I20051118000182 |
| Provider Name | Raymond Roitman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386777456 PECOS PAC ID: 0648299594 Enrollment ID: I20051121000336 |
| Provider Name | Erik A Levy |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1205861101 PECOS PAC ID: 6507969979 Enrollment ID: I20070306000292 |
| Provider Name | Claudia Zsigmond |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1801848932 PECOS PAC ID: 5890877484 Enrollment ID: I20080205000344 |
| Provider Name | Maryla I Madura |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841340809 PECOS PAC ID: 9133287451 Enrollment ID: I20081015000230 |
| Provider Name | Sergey P Litvinov |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669633129 PECOS PAC ID: 3870659600 Enrollment ID: I20090303000656 |
| Provider Name | Allison Daughn |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1821322843 PECOS PAC ID: 1557404589 Enrollment ID: I20100129000605 |
| Provider Name | Edward J Killeen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376578336 PECOS PAC ID: 9739132580 Enrollment ID: I20101004000082 |
| Provider Name | Denise A Dutchak Parmenter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518024348 PECOS PAC ID: 8820054679 Enrollment ID: I20101005000369 |
| Provider Name | Sivanta Paul |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215978887 PECOS PAC ID: 7416142229 Enrollment ID: I20101105000970 |
| Provider Name | Steven R Cohen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376680082 PECOS PAC ID: 9537068861 Enrollment ID: I20101115001111 |
| Provider Name | S Graham Kosch |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1528086329 PECOS PAC ID: 9133318561 Enrollment ID: I20110114000901 |
| 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 | Pritesh Parbhoo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1871863308 PECOS PAC ID: 2860669819 Enrollment ID: I20120117000145 |
| Provider Name | Justin M Roth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790096626 PECOS PAC ID: 4082871777 Enrollment ID: I20120208000495 |
| Provider Name | Anjali A Pathak |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558448928 PECOS PAC ID: 5890757793 Enrollment ID: I20120314000120 |
| Provider Name | Tiffany Schiffner |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316228950 PECOS PAC ID: 9931369113 Enrollment ID: I20120326000523 |
| Provider Name | Jody E Mountcastle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689791089 PECOS PAC ID: 3678735545 Enrollment ID: I20120510000501 |
| Provider Name | Paul H Wurst |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366448615 PECOS PAC ID: 0840297966 Enrollment ID: I20120524000291 |
| Provider Name | Michael Joseph Amiel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245254937 PECOS PAC ID: 1456515550 Enrollment ID: I20120620000578 |
| Provider Name | Paul Zitowitz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467453795 PECOS PAC ID: 8820095219 Enrollment ID: I20120913000674 |
| Provider Name | Andrew A Sappington |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063502383 PECOS PAC ID: 7618877333 Enrollment ID: I20120926000346 |
| 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 | Gerald Rivera |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538318712 PECOS PAC ID: 9537312012 Enrollment ID: I20130111000324 |
| Provider Name | Katherine J Baum |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841370657 PECOS PAC ID: 7810934411 Enrollment ID: I20130411000128 |
| 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 | Geraldine Diane Rodrigues-pratt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255499133 PECOS PAC ID: 1254575970 Enrollment ID: I20130919000660 |
| Provider Name | Lynne Carroll |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1578999249 PECOS PAC ID: 9335373430 Enrollment ID: I20131003000116 |
| Provider Name | Cindy Karen Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073847075 PECOS PAC ID: 6709017775 Enrollment ID: I20140317001181 |
| Provider Name | Stuart Samuel Burstein |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366522930 PECOS PAC ID: 0446250492 Enrollment ID: I20140415001556 |
| 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 | Sajida Mathew |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164510509 PECOS PAC ID: 1850284233 Enrollment ID: I20140822001363 |
| Provider Name | Marco A Rabines |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780833038 PECOS PAC ID: 5597912055 Enrollment ID: I20140828001414 |
| Provider Name | Louis Theodore Joseph |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013167170 PECOS PAC ID: 0941471726 Enrollment ID: I20141217001520 |
| 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 | Daniel Howard Kretchman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1487943536 PECOS PAC ID: 4880911270 Enrollment ID: I20150324000780 |
| Provider Name | Martha E Wisbey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598158867 PECOS PAC ID: 5496076887 Enrollment ID: I20150610002669 |
| Provider Name | John Draeger |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023161601 PECOS PAC ID: 9830103068 Enrollment ID: I20150923002636 |
| Provider Name | Jennifer Fleeman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790748416 PECOS PAC ID: 7113814443 Enrollment ID: I20151102000904 |
| Provider Name | Judi Mcinerney |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1083624498 PECOS PAC ID: 6507814324 Enrollment ID: I20151217001233 |
| Provider Name | Yasmine Declama Holbrook |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649667767 PECOS PAC ID: 6800190901 Enrollment ID: I20160210002472 |
| Provider Name | Nicholas Mckinnon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962676668 PECOS PAC ID: 0749585891 Enrollment ID: I20160226001266 |
| Provider Name | Francy N Fonseca |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437517778 PECOS PAC ID: 4183920879 Enrollment ID: I20160307000601 |
| Provider Name | Babur Hafeez Bhatti |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245525781 PECOS PAC ID: 4587959978 Enrollment ID: I20160824001717 |
| Provider Name | Lauren M Woodruff |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053539098 PECOS PAC ID: 1951689868 Enrollment ID: I20161027001961 |
| Provider Name | Justin M Simpson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1407153471 PECOS PAC ID: 3476724303 Enrollment ID: I20170202000651 |
| Provider Name | Douglas Shine |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992821201 PECOS PAC ID: 0244513323 Enrollment ID: I20170215002743 |
| 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 | Heather N Gillum |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881682227 PECOS PAC ID: 8820157019 Enrollment ID: I20170905000322 |
| Provider Name | Deborah Knudson Gonzalez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104016633 PECOS PAC ID: 3476733809 Enrollment ID: I20171003004681 |
| Provider Name | John A Ireland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639572720 PECOS PAC ID: 6800162991 Enrollment ID: I20171017002161 |
| Provider Name | Gesenia Sloan-pena |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437380490 PECOS PAC ID: 7911263165 Enrollment ID: I20171104000173 |
| Provider Name | Blanche M. Williams |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1336236637 PECOS PAC ID: 2365502523 Enrollment ID: I20180105001361 |
| Provider Name | Bryson Dale Blackburn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891208393 PECOS PAC ID: 3971862418 Enrollment ID: I20180109001646 |
| 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 | Christopher Patrick Scanlon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215439971 PECOS PAC ID: 9537423926 Enrollment ID: I20180511001132 |
| Provider Name | James J Meeks |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740608983 PECOS PAC ID: 5496064594 Enrollment ID: I20180525001804 |
| Provider Name | Fred Sacklow |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619968716 PECOS PAC ID: 4981861002 Enrollment ID: I20180530003159 |
| Provider Name | Martin J Desantis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902091036 PECOS PAC ID: 0042480352 Enrollment ID: I20180724002684 |
| Provider Name | Chelsea Tepedino |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972829299 PECOS PAC ID: 4486998036 Enrollment ID: I20181207002024 |
| Provider Name | Lauren Gavron |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104307925 PECOS PAC ID: 0547505950 Enrollment ID: I20181212003005 |
| Provider Name | Yadira Nogueras-rosado |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962829853 PECOS PAC ID: 8628313830 Enrollment ID: I20181217001448 |
| Provider Name | Jacqueline Linda Henschke |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730202391 PECOS PAC ID: 9830270206 Enrollment ID: I20190115002499 |
| Provider Name | Sharon Paulette Johnson Hyatt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396210555 PECOS PAC ID: 6103162912 Enrollment ID: I20190116001609 |
| Provider Name | Justin Nepa |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932512118 PECOS PAC ID: 1850637455 Enrollment ID: I20190117002166 |
| Provider Name | Pwint P Phyu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831583384 PECOS PAC ID: 2365729191 Enrollment ID: I20190129001772 |
| 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 | Abigail M Patterson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1710222559 PECOS PAC ID: 5698015733 Enrollment ID: I20190327001753 |
| 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 | William F Dewolf |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346405511 PECOS PAC ID: 5799831954 Enrollment ID: I20190723000608 |
| 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 | Axel B Bouchard |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1962889139 PECOS PAC ID: 2365705761 Enrollment ID: I20190807000085 |
| Provider Name | Rebecca Edwards |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659925089 PECOS PAC ID: 1254660715 Enrollment ID: I20190909001287 |
| Provider Name | Alysa M Gregory |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639727316 PECOS PAC ID: 2466784467 Enrollment ID: I20191024000105 |
| Provider Name | Lorelle Destefano |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194185165 PECOS PAC ID: 0749574978 Enrollment ID: I20191218000142 |
| Provider Name | Carol Bender |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225585821 PECOS PAC ID: 2365870458 Enrollment ID: I20200324002497 |
| Provider Name | Cynthia Carnes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326670167 PECOS PAC ID: 1254769227 Enrollment ID: I20200325002887 |
| Provider Name | Alan Wolfson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376823955 PECOS PAC ID: 8123348034 Enrollment ID: I20200403001198 |
| Provider Name | Elizabeth A Hogan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376820316 PECOS PAC ID: 0143497859 Enrollment ID: I20200404000360 |
| 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 | Lindsey G. Gullo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760706261 PECOS PAC ID: 4880015189 Enrollment ID: I20200521002067 |
| Provider Name | Teresa Irene Bobo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437695202 PECOS PAC ID: 2769803816 Enrollment ID: I20200528001873 |
| Provider Name | Ebony S Vinson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396297628 PECOS PAC ID: 4385065358 Enrollment ID: I20200529000138 |
| Provider Name | Jahanara Zahid |
|---|---|
| Provider Type | Practitioner - Neuropsychiatry |
| Provider Identifiers | NPI Number: 1588822589 PECOS PAC ID: 5890949150 Enrollment ID: I20200603000962 |
| 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 | Melania Jean Macip-billbe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396350310 PECOS PAC ID: 2668882747 Enrollment ID: I20201030000709 |
| Provider Name | Sonia Demetrios |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598068579 PECOS PAC ID: 9335382464 Enrollment ID: I20201125000714 |
| Provider Name | Kelley M Haas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184991515 PECOS PAC ID: 0749694115 Enrollment ID: I20210126001210 |
| 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 | Mary Duncan Waters |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1215108329 PECOS PAC ID: 1951718733 Enrollment ID: I20210323000468 |
| 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 | Meredith S Mcconnell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659940005 PECOS PAC ID: 3375940398 Enrollment ID: I20210917001456 |
| 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 | Hemant K Thakur |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487672648 PECOS PAC ID: 4385868553 Enrollment ID: I20211021001541 |
| 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 | Brandi Clayton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346885886 PECOS PAC ID: 9931515582 Enrollment ID: I20220608000320 |
| Provider Name | Mamta H Shroff |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528701489 PECOS PAC ID: 1355720533 Enrollment ID: I20220617001234 |
| Provider Name | David Hahn |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1457347817 PECOS PAC ID: 3971569666 Enrollment ID: I20220819000245 |
| 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 | Steven Gary Kessler |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1043299456 PECOS PAC ID: 9335137801 Enrollment ID: I20221011000076 |
| 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 | Laura Farrell West |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184803637 PECOS PAC ID: 3375914195 Enrollment ID: I20230113001043 |
| 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 | Christopher Maniscalco |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821597162 PECOS PAC ID: 2163896598 Enrollment ID: I20230324002048 |
| 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 | Kara Anne Gans-page |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104520907 PECOS PAC ID: 2365802683 Enrollment ID: I20230719000253 |
| 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 | Toni Ann Serpe |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831443118 PECOS PAC ID: 5991168825 Enrollment ID: I20230825000610 |
| 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 | Geoffrey Tremont |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1043297880 PECOS PAC ID: 6800929530 Enrollment ID: I20230911004292 |
| Provider Name | Lissette Carmona-roman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1861718975 PECOS PAC ID: 5991169484 Enrollment ID: I20230918000964 |
| 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 | Michelle Elena Stack |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1952671950 PECOS PAC ID: 6406007962 Enrollment ID: I20240214003965 |
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 |