Healthcare Provider Details

I. General information

NPI: 1548192123
Provider Name (Legal Business Name): STAR PSYCHOLOGY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2026
Last Update Date: 05/30/2026
Certification Date: 05/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4720 CLEVELAND HEIGHTS BLVD STE 201
LAKELAND FL
33813-2245
US

IV. Provider business mailing address

4720 CLEVELAND HEIGHTS BLVD STE 201
LAKELAND FL
33813-2245
US

V. Phone/Fax

Practice location:
  • Phone: 863-225-8136
  • Fax: 863-279-1195
Mailing address:
  • Phone: 863-225-8136
  • Fax: 863-279-1195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. SHEYTOPHIA RENEE CUNHA
Title or Position: PRACTICE OWNER
Credential: PSYD, NCSP, ABSNP
Phone: 863-225-8136