Provider Demographics
NPI:1831704477
Name:LAURA CARNEVALE THERAPY, LLC
Entity type:Organization
Organization Name:LAURA CARNEVALE THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:CARNEVALE
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:941-586-4870
Mailing Address - Street 1:3944 RED ROCK LN
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-3541
Mailing Address - Country:US
Mailing Address - Phone:941-586-4870
Mailing Address - Fax:941-586-4870
Practice Address - Street 1:3944 RED ROCK LN
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-3541
Practice Address - Country:US
Practice Address - Phone:941-586-4870
Practice Address - Fax:941-586-4870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty