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General NPI Number Information
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NPI Number | 1336948520
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Entity Type | Organization
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Legal Business Name | UNIFIED THERAPY LLC
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Dates
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Enumeration Date | 03/10/2025
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 2033 WOOD ST STE 120
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City | SARASOTA
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State | FL
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Zip | 34237-7933
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Country | US
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Telephone | 941-928-8494
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Fax |
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Provider Business Mailing Address
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Address Line | 7503 AGUILA DR
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City | SARASOTA
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State | FL
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Zip | 34240-1467
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Country | US
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Telephone | 239-209-1994
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | PHILLIP D HENDRA
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Credential | LMHC
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Telephone | 239-209-1994
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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