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General NPI Number Information
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NPI Number | 1245155191
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Entity Type | Organization
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Legal Business Name | SILVER LEAF THERAPY LLC
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Dates
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Enumeration Date | 08/11/2026
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Last Update Date | 08/11/2026
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Provider Practice Location Address
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Address Line | 725 SE BAYA DR STE 105
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City | LAKE CITY
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State | FL
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Zip | 32025-6092
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Country | US
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Telephone | 406-461-1656
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Fax |
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Provider Business Mailing Address
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Address Line | 1633 NW NASH RD
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City | LAKE CITY
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State | FL
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Zip | 32055-8010
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DAVID PATRICK
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Credential | LCSW
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Telephone | 352-328-6219
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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