NPIMap

Organization Active NPI

Dna Comprehensive Therapy Services, LLC

  • Clinical Psychologist
  • Port Charlotte, FL
National Provider Identifier
1003351966
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
DNA COMPREHENSIVE THERAPY SERVICES, LLC
Practice address
19531 Cochran Blvd
Port Charlotte, FL 33948-2081
Phone
(239) 223-2751
NPI assigned
Jan 3, 2017
Organization subpart
Yes
Parent organization
DNA COMPREHENSIVE THERAPY SERVICES, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Elizabeth N. Dosoretz, LCSW
Title
Ceo
Phone
(239) 236-8784

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

19531 Cochran Blvd
Port Charlotte, FL 33948-2081

Mailing address

4310 Metro Pkwy Ste 205
Fort Myers, FL 33916-9416
Phone (833) 362-7935

Other identifiers 2

IdentifierTypeStateIssuer
010785500MedicaidFL
014482100MedicaidFL

Other names 1

  • ELITE DNA THERAPY SERVICES, LLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dna Comprehensive Therapy67 organizations share this tax ID, including this one
Part of
Dna Comprehensive Therapy

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13142/brand/1/csg/1/fhir/r4

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1483401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750723200000",
    "number": "1003351966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 METRO PKWY STE 205",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339169416",
            "telephone_number": "833-362-7935",
            "fax_number": "239-561-2933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19531 COCHRAN BLVD",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339482081",
            "telephone_number": "239-223-2751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DNA COMPREHENSIVE THERAPY SERVICES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DNA COMPREHENSIVE THERAPY SERVICES, LLC",
        "enumeration_date": "2017-01-03",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-04",
        "status": "A",
        "authorized_official_last_name": "DOSORETZ",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "239-236-8784",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010785500",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014482100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ELITE DNA THERAPY SERVICES, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ELITE DNA THERAPY SERVICES, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.