Organization
SANDPIPER WELLNESS & THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN MARINO (CHAIRMAN)
(772) 800-3990
Entity
Organization
Contact information
Practice address
1405 SE GOLDTREE DR STE D, PORT SAINT LUCIE, FL 34952-7563
(772) 800-3990
(772) 621-2977
Mailing address
1405 SE GOLDTREE DR STE D, PORT SAINT LUCIE, FL 34952-7563
(772) 800-3990
(772) 621-2977
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
5646277703302
FL
101YM0800X
Mental Health Counselor
5646277703302
FL
101YP2500X
Professional Counselor
5646277703302
FL
208D00000X
General Practice Physician
—
FL
208D00000X
General Practice Physician
—
—
261QR0400X
Rehabilitation Clinic/Center
Primary
HCC10590
FL
324500000X
Substance Abuse Rehabilitation Facility
5646277703302
FL
Other
Enumeration date
08/20/2014
Last updated
11/01/2017
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