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Organization
STATERA PSYCHOTHERAPY LLC
Active
Organization
STATERA PSYCHOTHERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATALIN VINCZI-SIERRA LCSW (MEMBER-MANAGER)
(813) 438-6115
Entity
Organization
Contact information
Practice address
19730 MORDEN BLUSH DR, LUTZ, FL 33558-9088
(813) 438-6115
(813) 296-2115
Mailing address
19730 MORDEN BLUSH DR, LUTZ, FL 33558-9088
(813) 438-6115
(813) 296-2115
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
08/11/2022
Last updated
08/11/2022
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