DNA COMPREHENSIVE THERAPY SERVICES LLC NPI 1316363757

NPI Information

NPI: 1316363757
Provider Name: DNA COMPREHENSIVE THERAPY SERVICES, LLC

Doing Business As: ELITE DNA THERAPY SERVICES

Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
4310 METRO PKWY STE 205
FORT MYERS, FL
ZIP 33916
Phone: (239) 223-2751
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DNA COMPREHENSIVE THERAPY SERVICES, LLC is a mental health (including community mental health center) clinic center in Fort Myers, FL. DNA COMPREHENSIVE THERAPY SERVICES, LLC NPI is 1316363757. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Elite Dna Therapy Services.

The provider's business location address is:

4310 METRO PKWY STE 205
FORT MYERS, FL
ZIP 33916-416
Phone: (239) 223-2751
Fax: (239) 561-2933

The provider's authorized official is Elizabeth Dosoretz .
The authorized official title is President and has the following contact phone number (239) 223-2751.

The enumeration date for this NPI number is 3/10/2014 and was last updated on 9/30/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	101YM0800X	Counselor	Mental Health	No
2	103K00000X	Behavior Analyst		No
3	103TC0700X	Psychologist	Clinical	No
4	1041C0700X	Social Worker	Clinical	No
5	2084N0600X	Psychiatry & Neurology	Clinical Neurophysiology	No
6	207QA0401X	Family Medicine	Addiction Medicine	No
7	2084A0401X	Psychiatry & Neurology	Addiction Medicine	No
8	225X00000X	Occupational Therapist		No
9	2084P0800X	Psychiatry & Neurology	Psychiatry	No
10	2084P0804X	Psychiatry & Neurology	Child & Adolescent Psychiatry	No
11	225XP0200X	Occupational Therapist	Pediatrics	No
12	235Z00000X	Speech-Language Pathologist		No
13	261QM0855X	Clinic/Center	Adolescent and Children Mental Health	No
14	261QM1300X	Clinic/Center	Multi-Specialty	No
15	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	010784000	MEDICAID	FLORIDA
2	022832900	MEDICAID	FLORIDA
3	010785500	MEDICAID	FLORIDA
4	010785508	MEDICAID	FLORIDA
5	017439500	MEDICAID	FLORIDA
6	010785506	MEDICAID	FLORIDA
7	010785504	MEDICAID	FLORIDA
8	010785509	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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