MEDICARE: SARASOTA THERAPY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	SW8549	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245660828
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SARASOTA THERAPY, LLC

Provider Business Mailing Address
First Line	:	1034 GREYSTONE LN
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34232-2100
Country	:	US
Telephone Number	:	941-587-2055
Fax Number	:	941-371-3549

Provider Business Practice Location Address
First Line	:	5971 CATTLEMEN LN
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34232-6200
Country	:	US
Telephone Number	:	941-587-2055
Fax Number	:	941-371-3549

Authorized Official
Title or Position	:	OWNER
Name	:	MS. AMY THATCHER
Credential	:	LCSW
Telephone Number	:	941-587-2055

Provider Enumeration Date	:	11/19/2013
Last Update Date	:	12/14/2016

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Directions to “SARASOTA THERAPY, LLC ” Practice Location

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