Healthcare Provider Details

I. General information

NPI: 1033076914
Provider Name (Legal Business Name): MENTAL HEALTH SHEERPA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2026
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 TAMIAMI TRL S STE 101
VENICE FL
34285-4133
US

IV. Provider business mailing address

885 FAIRFAX TER NW
PORT CHARLOTTE FL
33948-3718
US

V. Phone/Fax

Practice location:
  • Phone: 786-521-1599
  • Fax:
Mailing address:
  • Phone: 786-521-1599
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MELANIE ANTONES
Title or Position: PRESIDENT
Credential: LCSW
Phone: 786-521-1599