| Kdilly Foundation, Inc. | |
|
2759 State Road 580 Ste 111 Clearwater FL 33761-3352 | |
| (727) 866-4682 | |
| (727) 380-5684 |
| Full Name | Kdilly Foundation, Inc. |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2759 State Road 580 Ste 111, Clearwater, Florida |
| Authorized Official Name and Position | Tracy L Sisk (EXECUTIVE/CLINICAL DIRECTOR) |
| Authorized Official Contact | 7278664682 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kdilly Foundation, Inc. 2759 State Road 580 Ste 111 Clearwater FL 33761-3352 Ph: (727) 866-4682 | Kdilly Foundation, Inc. 2759 State Road 580 Ste 111 Clearwater FL 33761-3352 Ph: (727) 866-4682 |
| NPI Number | 1144158411 |
|---|---|
| Provider Enumeration Date | 05/08/2026 |
| Last Update Date | 05/08/2026 |
| Certification Date | 05/08/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144158411 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (NU) | Primary |
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