Provider Demographics
NPI:1194102533
Name:CYPRESS CREEK THERAPY & RELATIONSHIP CENTER, INC
Entity type:Organization
Organization Name:CYPRESS CREEK THERAPY & RELATIONSHIP CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:BERNER
Authorized Official - Last Name:ARCURI
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:941-920-0189
Mailing Address - Street 1:11755 SHIRBURN CIR
Mailing Address - Street 2:
Mailing Address - City:PARRISH
Mailing Address - State:FL
Mailing Address - Zip Code:34219-7508
Mailing Address - Country:US
Mailing Address - Phone:941-920-0189
Mailing Address - Fax:941-747-8714
Practice Address - Street 1:703 60TH STREET CT E
Practice Address - Street 2:SUITE C
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-6278
Practice Address - Country:US
Practice Address - Phone:941-920-0189
Practice Address - Fax:941-747-8714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-06
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH4329101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty