Provider Demographics
NPI:1952793069
Name:CJS PSYCHOTHERAPY ASSOCIATES, LLC
Entity Type:Organization
Organization Name:CJS PSYCHOTHERAPY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:SANTINI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:646-388-3422
Mailing Address - Street 1:1270 CLEBURNE DR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-1609
Mailing Address - Country:US
Mailing Address - Phone:646-388-3422
Mailing Address - Fax:
Practice Address - Street 1:11470 S CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-2323
Practice Address - Country:US
Practice Address - Phone:239-489-2225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-26
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 121131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty