Organization Active NPI

Landry Therapy and Wellness

  • Mental Health Counselor
  • Port Charlotte, FL
National Provider Identifier
1639890221
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
LANDRY THERAPY AND WELLNESS
Practice address
1720 El Jobean Rd Unit 202
Port Charlotte, FL 33948-1279
Phone
(941) 524-2673
Fax
(941) 240-9027
NPI assigned
Sep 12, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

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

Authorized official

Name
Katie Landry
Title
Cfo
Phone
(941) 524-2673

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

1720 El Jobean Rd Unit 202
Port Charlotte, FL 33948-1279

Mailing address

16896 Sol Preserve Dr
Port Charlotte, FL 33953-2295
Phone (941) 524-2673

Other practice location 1

1500 E Venice Ave Unit 408
Venice, FL 34292-1660
Phone (941) 524-2673

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260518002232 FL Part B Supplier - Clinic/Group Practice 4284103417 Receives reassigned benefits from 1 practitioner
Practice locations: Port Charlotte, FL; Venice, FL

National Provider Directory

National Provider Directory

Locations

1720 El Jobean Rd
Unit 202
Port Charlotte, FL 33948
Phone (941) 524-2673

1500 E Venice Ave
Unit 408
Venice, FL 34292
Phone (941) 524-2673

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776038400000",
    "number": "1639890221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16896 SOL PRESERVE DR",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339532295",
            "telephone_number": "941-524-2673",
            "fax_number": "941-240-9027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 EL JOBEAN RD UNIT 202",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339481279",
            "telephone_number": "941-524-2673",
            "fax_number": "941-240-9027"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 E Venice Ave Unit 408",
            "address_purpose": "LOCATION",
            "city": "Venice",
            "state": "FL",
            "postal_code": "342921660",
            "country_code": "US",
            "telephone_number": "941-524-2673",
            "fax_number": "941-240-9027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LANDRY THERAPY AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-12",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A",
        "authorized_official_last_name": "LANDRY",
        "authorized_official_first_name": "KATIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "941-524-2673"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.