Healthcare Provider Details

I. General information

NPI: 1013359926
Provider Name (Legal Business Name): CENTERPOINTE COUNSELING AND RECOVERY OF SARASOTA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2013
Last Update Date: 08/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 COMMERCIAL CT SIUTE 100
VENICE FL
34292-1648
US

IV. Provider business mailing address

425 COMMERCIAL CT SIUTE 100
VENICE FL
34292-1648
US

V. Phone/Fax

Practice location:
  • Phone: 941-488-4811
  • Fax: 941-488-4899
Mailing address:
  • Phone: 941-488-4811
  • Fax: 941-488-4899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. CARRIE LYNN PHELPS
Title or Position: DIRECTOR/ THERAPIST
Credential: LMHC, CAP
Phone: 941-915-8167