Individual provider Active NPI

Theda Sturm, LMFT

  • Marriage & Family Therapist
  • Eustis, FL
National Provider Identifier
1851638720
Registry record updated Jan 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MT 2744 Issued in FL
Practice address
201 E Magnolia Ave
Eustis, FL 32726-3583
Phone
(352) 315-7100
Fax
(352) 360-6582
NPI assigned
Jan 11, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MT 2744 FL Primary

Addresses

Primary practice location

201 E Magnolia Ave
Eustis, FL 32726-3583

Mailing address

4232 Lake Eleanor Dr
Mount Dora, FL 32757-4302
Phone (352) 315-7100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240828005397 FL Practitioner - Marriage and Family Therapist 3375082712 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807
Phone (786) 244-7711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MT 2744FLMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Marriage & Family Therapist CurrentSince Jul 22, 2024 Accepting new patients
Lifestream Behavioral Center Inc Past Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1357862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357862400000",
    "number": "1851638720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4232 LAKE ELEANOR DR",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327574302",
            "telephone_number": "352-315-7100",
            "fax_number": "352-360-6582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E MAGNOLIA AVE",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327263583",
            "telephone_number": "352-315-7100",
            "fax_number": "352-360-6582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STURM",
        "first_name": "THEDA",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-11",
        "last_updated": "2013-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT 2744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eustis, FL

Sources for this page

Verify at the official NPI Registry.