CENTRAL FLORIDA PSYCHOTHERAPY SERVICES LLC (NPI# 1689286809) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689286809 |
| Entity Type | Organization |
| Organization Name | CENTRAL FLORIDA PSYCHOTHERAPY SERVICES LLC |
| Practice Address |
5302 S Florida Ave Ste 200 Lakeland FL 33813-4922 |
| Mailing Address |
5302 S Florida Ave Ste 203 Lakeland FL 33813-4910 |
| Practice Telephone | 8536027001 |
| Practice Fax Number | 8635838585 |
| Mailing Telephone | 8636027001 |
| Mailing Fax Number | 8635838585 |
| Enumeration Date | 2020-08-19 |
| Last Update Date | 2020-08-19 |
| Authorized Official Name | JOMON THEKKETHOTTIYIL (OWNER) |
| Authorized Official Telephone | 3304163867 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Psychotherapy Services of Newlight | Doing Business As Name - Organization |
| Street Address |
5302 S FLORIDA AVE STE 200 |
| City | LAKELAND |
| State | FL |
| Zip Code | 33813-4922 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427600030 | Genesis Vieyra Lopez | Nurse Practitioner | 631 Mid Florida Drive, Lakeland, FL 33813 | 2019-07-13 |
| 1306323340 | Sandrene Smart | Clinic/Center | 625 Commerce Dr. (suite 103), Lakeland, FL 33813 | 2018-07-23 |
| 1033560586 | Charles D. Llano, D.d.s. | Dentist | 320 West Highland Drive, Lakeland, FL 33813 | 2016-06-27 |
| 1417317389 | Eye Specialists of Mid-florida, Pa | Ophthalmology | 2004 Cr 540 A, Lakeland, FL 33813 | 2016-03-04 |
| 1609234905 | Care and Life LLC | In Home Supportive Care | 6526 Fox Tree Lane, Lakeland, FL 33813 | 2016-02-02 |
| 1558731158 | Lori Ann Smith | Nurse Practitioner | 6030 S. Florida Ave, Suite 110, Lakeland, FL 33813 | 2015-09-25 |
| 1891182143 | Advanced Integrated Care Organization, LLC | Health Maintenance Organization | 5423 S. Florida Ave, Lakeland, FL 33813 | 2015-04-23 |
| 1902292352 | Central Health Associates | Internal Medicine | 4925 Old Rd 37, Lakeland, FL 33813 | 2015-04-13 |
| 1134542848 | Gledia Lovering | Dietitian, Registered | 6420 Highlands In The Woods St, Lakeland, FL 33813 | 2014-01-31 |
| 1134556368 | Billy Rogers | Nurse Anesthetist, Certified Registered | 4513 Orangewood Loop W., Lakeland, FL 33813 | 2013-10-02 |
| Find all providers in zip 33813 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639797582 | Maron Sabol | Social Worker | 307a W Main St, Lakeland, FL 33815-1555 | 2020-07-08 |
| 1891335188 | Atala Counseling, Pllc | Social Worker | 1867 N Crystal Lake Dr, Lakeland, FL 33801-5955 | 2020-01-14 |
| 1659920213 | Curlene Williams | Social Worker | 4302 Glennis Dr, Lakeland, FL 33813-1914 | 2019-09-06 |
| 1386293926 | Melissa Sue Meyer | Social Worker | 348 W Highland Dr, Lakeland, FL 33813-1543 | 2019-09-06 |
| 1215581939 | Melissa F Deroxtro | Social Worker | 1014 S Florida Ave Ste 102, Lakeland, FL 33803-1130 | 2019-07-31 |
| 1831655471 | Susan Marie Coulter | Social Worker | 924 Old Polk City Rd, Lakeland, FL 33809-2335 | 2019-02-19 |
| 1811495096 | Suzanne Brabant | Social Worker | 8179 Westmont Terrace Drive, Lakeland, FL 33810 | 2018-01-23 |
| 1477905917 | Lauren Dentler | Social Worker | 4175 Mayfair Way, Lakeland, FL 33812-0824 | 2016-07-08 |
| 1447600846 | Jenna Nielsen | Social Worker | 1065 Clearpointe Way, Lakeland, FL 33813-5618 | 2016-06-16 |
| 1841656311 | Melissa Emily Wallace | Social Worker | 1014 S Florida Ave Fl 2, Lakeland, FL 33803-1130 | 2016-01-13 |
| Find all providers in LAKELAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.