Stephanie Wentworth

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MT3180 Issued in FL

Legal business name

STEPHANIE WENTWORTH

Practice address

1219 Millennium Pkwy
Suite 116
Brandon, FL 33511-3879

Phone

(813) 391-3495

NPI assigned

Feb 20, 2017

Organization subpart

No

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

Authorized official

Name

Stephanie Wentworth

Title

Owner

Phone

(813) 391-3495

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1487548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487548800000",
    "number": "1063951309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1219 MILLENNIUM PKWY",
            "address_2": "SUITE 116",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335113879",
            "telephone_number": "813-391-3495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1219 MILLENNIUM PKWY",
            "address_2": "SUITE 116",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335113879",
            "telephone_number": "813-391-3495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHANIE WENTWORTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-20",
        "last_updated": "2017-02-20",
        "status": "A",
        "authorized_official_last_name": "WENTWORTH",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-391-3495"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT3180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Brandon, FL
• Providers in Brandon, FL by specialty
• Marriage & Family Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2017; 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.