Provider Demographics
NPI:1760259618
Name:DRAGON'S ROOST THERAPY
Entity Type:Organization
Organization Name:DRAGON'S ROOST THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:MERCIER-KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:941-879-6186
Mailing Address - Street 1:8489 CAMPUS WOODS WAY
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-4731
Mailing Address - Country:US
Mailing Address - Phone:941-879-6186
Mailing Address - Fax:
Practice Address - Street 1:8489 CAMPUS WOODS WAY
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34655-4731
Practice Address - Country:US
Practice Address - Phone:941-879-6186
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty