Provider Demographics
NPI:1336948520
Name:UNIFIED THERAPY LLC
Entity type:Organization
Organization Name:UNIFIED THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:D
Authorized Official - Last Name:HENDRA
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:239-209-1994
Mailing Address - Street 1:7503 AGUILA DR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34240-1467
Mailing Address - Country:US
Mailing Address - Phone:239-209-1994
Mailing Address - Fax:
Practice Address - Street 1:2033 WOOD ST STE 120
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-7933
Practice Address - Country:US
Practice Address - Phone:941-928-8494
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-10
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty