Provider Demographics
NPI:1700672623
Name:STORYARC THERAPY LLC
Entity type:Organization
Organization Name:STORYARC THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAMILLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:850-624-0584
Mailing Address - Street 1:4035 OSPREY PT
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32409-2129
Mailing Address - Country:US
Mailing Address - Phone:850-624-0584
Mailing Address - Fax:850-248-2468
Practice Address - Street 1:4102 W HIGHWAY 390
Practice Address - Street 2:
Practice Address - City:LYNN HAVEN
Practice Address - State:FL
Practice Address - Zip Code:32444-4580
Practice Address - Country:US
Practice Address - Phone:850-624-0584
Practice Address - Fax:850-248-2469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty