| Therapy Treatment Team Llc | |
|
12811 Kenwood Ln Ste 202 Fort Myers FL 33907-5646 | |
| (239) 537-9646 | |
| Not Available |
| Full Name | Therapy Treatment Team Llc |
|---|---|
| Speciality | Counselor |
| Location | 12811 Kenwood Ln Ste 202, Fort Myers, Florida |
| Authorized Official Name and Position | Yaroslaba Garcia (CLINICAL OPERATIONS DIRECTOR) |
| Authorized Official Contact | 2395379646 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Therapy Treatment Team Llc 12811 Kenwood Ln Ste 202 Fort Myers FL 33907-5646 Ph: (239) 537-9646 | Therapy Treatment Team Llc 12811 Kenwood Ln Ste 202 Fort Myers FL 33907-5646 Ph: (239) 537-9646 |
| NPI Number | 1053858316 |
|---|---|
| Provider Enumeration Date | 01/25/2017 |
| Last Update Date | 12/12/2019 |
| Certification Date | 12/12/2019 |
| Medicare PECOS PAC ID | 0446594451 |
|---|---|
| Medicare Enrollment ID | O20190603001907 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053858316 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MH11374 (Florida) | Primary |
| Provider Name | Elizabeth M Carroll Attella |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205492261 PECOS PAC ID: 2062747488 Enrollment ID: I20190708002103 |
| Provider Name | Septimio Julio Gonzalez Savournin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053962589 PECOS PAC ID: 9234565409 Enrollment ID: I20200206001307 |
| Provider Name | Heather Elizabeth Mossotti |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588202352 PECOS PAC ID: 0547645566 Enrollment ID: I20220912002479 |
| Provider Name | Catherine S Moore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982816773 PECOS PAC ID: 3779761895 Enrollment ID: I20221019003450 |
| Provider Name | Mara Bernard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275716359 PECOS PAC ID: 5799847828 Enrollment ID: I20230128000484 |
| Provider Name | Ashley Ann Gori |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174210660 PECOS PAC ID: 8527427970 Enrollment ID: I20230704000190 |
| Provider Name | Dustin Bower |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568140283 PECOS PAC ID: 5597129080 Enrollment ID: I20230918000691 |
| Provider Name | Terena Landowski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700584604 PECOS PAC ID: 0648625996 Enrollment ID: I20231006001664 |
| Provider Name | Sheri Montgomery |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1942658414 PECOS PAC ID: 4688022304 Enrollment ID: I20231118000325 |
| Provider Name | Crystal Lane |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811633845 PECOS PAC ID: 4789061102 Enrollment ID: I20231207000310 |
| Provider Name | Julie Ann Jakobi |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295258994 PECOS PAC ID: 1850735846 Enrollment ID: I20240218000111 |
| Provider Name | Tonya E Sletta |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1215241336 PECOS PAC ID: 2365886215 Enrollment ID: I20240219002029 |
| Provider Name | Vicki Lynne Bonham |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1881316776 PECOS PAC ID: 0941645063 Enrollment ID: I20240228004012 |
| Provider Name | David Lawrence Pezzullo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720673841 PECOS PAC ID: 2466897244 Enrollment ID: I20240303000050 |
| Provider Name | Patricia Ann Nasuti |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265762876 PECOS PAC ID: 3274978903 Enrollment ID: I20240304001747 |
| Provider Name | Melissa Sue Turvey-seabury |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275056061 PECOS PAC ID: 7911343926 Enrollment ID: I20240313001563 |
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