Healthcare Provider Details

I. General information

NPI: 1821481664
Provider Name (Legal Business Name): A NEW LIFE THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2015
Last Update Date: 03/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5327 COMMERCIAL WAY SUITE C115
SPRING HILL FL
34606-1448
US

IV. Provider business mailing address

4054 LONGBRANCH CT
SPRING HILL FL
34606-6837
US

V. Phone/Fax

Practice location:
  • Phone: 352-597-5497
  • Fax: 352-597-1662
Mailing address:
  • Phone: 813-716-8656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number12243
License Number StateFL

VIII. Authorized Official

Name: SARAH E SHIRINA
Title or Position: THERAPIST / CEO
Credential: LCSW
Phone: 813-716-8656