Provider Demographics
NPI:1558177295
Name:IN YOUR ELEMENT THERAPY
Entity type:Organization
Organization Name:IN YOUR ELEMENT THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SCIANDRA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:954-732-1158
Mailing Address - Street 1:200 HERITAGE CIR APT 406
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30114-5686
Mailing Address - Country:US
Mailing Address - Phone:954-732-1158
Mailing Address - Fax:
Practice Address - Street 1:200 HERITAGE CIR APT 406
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30114-5686
Practice Address - Country:US
Practice Address - Phone:954-732-1158
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-07
Last Update Date:2024-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health