Provider Demographics
NPI:1902402076
Name:STERLING COGNITIVE WELLNESS LLC
Entity Type:Organization
Organization Name:STERLING COGNITIVE WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SCULLION STERLING
Authorized Official - Suffix:
Authorized Official - Credentials:MB
Authorized Official - Phone:727-386-6003
Mailing Address - Street 1:525 BAYWOOD DR N
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-2008
Mailing Address - Country:US
Mailing Address - Phone:727-386-6003
Mailing Address - Fax:
Practice Address - Street 1:525 BAYWOOD DR N
Practice Address - Street 2:
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-2008
Practice Address - Country:US
Practice Address - Phone:727-386-6003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-04
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Single Specialty