MEDICARE: DNA COMPREHENSIVE THERAPY SERVICES, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101Y00000X	Counselor
2	103K00000X	Behavior Analyst
3	103TC0700X	Clinical Psychologist
4	104100000X	Social Worker
5	2084P0800X	Psychiatry Physician
6	225X00000X	Occupational Therapist
7	235Z00000X	Speech-Language Pathologist
8	363L00000X	Nurse Practitioner
9	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1952294084
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DNA COMPREHENSIVE THERAPY SERVICES, LLC

Provider Business Mailing Address
First Line	:	4310 METRO PKWY STE 205
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33916-9416
Country	:	US
Telephone Number	:	239-690-6906
Fax Number	:

Provider Business Practice Location Address
First Line	:	13101 TELECOM DR STE 120
Second Line	:
City	:	TEMPLE TERRACE
State	:	FL
Zip	:	33637-0936
Country	:	US
Telephone Number	:	239-833-3627
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ELIZABETH NOEMI DOSORETZ
Credential	:	LCSW
Telephone Number	:	239-223-2751

Provider Enumeration Date	:	05/29/2025
Last Update Date	:	06/24/2025

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