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2500 Bobcat Village Center Rd Unit F North Port FL 34288-8476 | |
(954) 676-8860 | |
(888) 821-8320 |
Full Name | |
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Speciality | Social Worker |
Location | 2500 Bobcat Village Center Rd Unit F, North Port, Florida |
Authorized Official Name and Position | Sandra Anne Landers (PSYCHOTHERAPIST) |
Authorized Official Contact | 9546687689 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 494081 Port Charlotte FL 33949-4080 Ph: (954) 668-7689 | 2500 Bobcat Village Center Rd Unit F North Port FL 34288-8476 Ph: (954) 676-8860 |
NPI Number | 1134219215 |
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Provider Enumeration Date | 10/13/2006 |
Last Update Date | 08/16/2021 |
Certification Date | 08/16/2021 |
Medicare PECOS PAC ID | 7517362155 |
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Medicare Enrollment ID | O20210820000249 |
Identifier | Type | State | Issuer |
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1134219215 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101Y00000X | Counselor | SW 5153 (Florida) | Secondary |
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Sandra A Landers |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1871770701 PECOS PAC ID: 5799775300 Enrollment ID: I20040515000265 |
Centerplace Health, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6919 Outreach Way, North Port, FL 34287 Phone: 941-529-0200 | |
Pediatric Behavioral Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4160 Oceanside St, North Port, FL 34286 Phone: 863-529-2183 | |