Provider Demographics
NPI:1013148261
Name:STRUCTURAL ENERGETIC THERAPY INC
Entity Type:Organization
Organization Name:STRUCTURAL ENERGETIC THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:B
Authorized Official - Last Name:MCCANN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:813-949-2933
Mailing Address - Street 1:156B WHITAKER RD
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33544-5792
Mailing Address - Country:US
Mailing Address - Phone:813-949-2933
Mailing Address - Fax:813-944-2797
Practice Address - Street 1:156B WHITAKER RD
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33544-5792
Practice Address - Country:US
Practice Address - Phone:813-949-2933
Practice Address - Fax:813-944-2797
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STRUCTURAL ENERGETIC THERAPY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-08-06
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH705101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty