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NPI Code Detail

MEDICARE: DNA COMPREHENSIVE THERAPY SERVICES, LLC

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 License Number License Number State
1101Y00000XCounselor
2103K00000XBehavior Analyst
3103TC0700XClinical Psychologist
4104100000XSocial Worker
52084P0800XPsychiatry Physician
6225X00000XOccupational Therapist
7235Z00000XSpeech-Language Pathologist
8363L00000XNurse Practitioner
9261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1972175362
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 : 239-236-8784
Fax Number : 239-790-2624
Provider Business Practice Location Address
First Line : 2230 VENETIAN CT STE 1
Second Line :
City : NAPLES
State : FL
Zip : 34109-8727
Country : US
Telephone Number : 239-236-5448
Fax Number : 239-631-8470
Authorized Official
Title or Position : CEO
Name : ELIZABETH DOSORETZ
Credential :
Telephone Number : 239-236-8784
Provider Enumeration Date : 07/14/2021
Last Update Date : 06/05/2025

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