NPIMap

Organization Active NPI

SRQ Life Therapy

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Sarasota, FL
National Provider Identifier
1164909388
Registry record updated Jul 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
SRQ LIFE THERAPY
Practice address
2477 Stickney Point Rd Ste 115B
Sarasota, FL 34231-4092
Phone
(941) 685-7148
NPI assigned
Jul 20, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2018

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

Authorized official

Name
Jodie Haber, LCSWNPI 1942589163
Title
Owner
Phone
(941) 685-7148

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

2477 Stickney Point Rd Ste 115B
Sarasota, FL 34231-4092

Mailing address

2477 Stickney Point Rd Ste 115B
Sarasota, FL 34231-4092

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1532044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532044800000",
    "number": "1164909388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2477 STICKNEY POINT RD STE 115B",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342314092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2477 STICKNEY POINT RD STE 115B",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342314092",
            "telephone_number": "941-685-7148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SRQ LIFE THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-20",
        "last_updated": "2018-07-20",
        "status": "A",
        "authorized_official_last_name": "HABER",
        "authorized_official_first_name": "JODIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-685-7148",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2018; 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.