Provider Demographics
NPI:1669693651
Name:SARASOTA PSYCHOLOGY SERVICES LLC
Entity type:Organization
Organization Name:SARASOTA PSYCHOLOGY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER-DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:941-955-5500
Mailing Address - Street 1:3205 SOUTHGATE CIR
Mailing Address - Street 2:#9
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-5514
Mailing Address - Country:US
Mailing Address - Phone:941-955-5500
Mailing Address - Fax:
Practice Address - Street 1:3205 SOUTHGATE CIR
Practice Address - Street 2:#9
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-5514
Practice Address - Country:US
Practice Address - Phone:941-955-5500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY5415103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty