Provider Demographics
NPI:1841916061
Name:KES THERAPY LLC
Entity type:Organization
Organization Name:KES THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHULLER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:201-627-9779
Mailing Address - Street 1:8348 NANDINA DR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34240-9523
Mailing Address - Country:US
Mailing Address - Phone:201-627-9779
Mailing Address - Fax:
Practice Address - Street 1:8348 NANDINA DR
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34240-9523
Practice Address - Country:US
Practice Address - Phone:201-627-9779
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-19
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty