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Organization
SPIRITED AWAY ART THERAPY, LLC
Active
Organization
SPIRITED AWAY ART THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA RW RICHARDSON LMHC, LPC (LMHC, ART THERAPIST)
(941) 882-0590
Entity
Organization
Contact information
Practice address
1505 TAMIAMI TRL S STE 402, VENICE, FL 34285-5563
(941) 882-0590
Mailing address
1607 LARCHWOOD DR, VENICE, FL 34293-1016
(941) 296-5759
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH11228
FL
101YP2500X
Professional Counselor
MH11228
FL
221700000X
Art Therapist
MH11228
FL
251S00000X
Community/Behavioral Health Agency
—
CT
251S00000X
Community/Behavioral Health Agency
—
FL
Other
Enumeration date
02/21/2013
Last updated
08/26/2019
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