Provider Demographics
NPI:1730757303
Name:WINDING ARBORS MENTAL HEALTH LLC
Entity type:Organization
Organization Name:WINDING ARBORS MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATER
Authorized Official - Prefix:MR
Authorized Official - First Name:JARRYD
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:LUNGER
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, APRN, PMHNP-BC
Authorized Official - Phone:727-334-1546
Mailing Address - Street 1:2600 1ST AVE S
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33712-1108
Mailing Address - Country:US
Mailing Address - Phone:727-334-1546
Mailing Address - Fax:727-608-2974
Practice Address - Street 1:2961 1ST AVE N STE C
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-8605
Practice Address - Country:US
Practice Address - Phone:727-334-1546
Practice Address - Fax:727-608-2974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-11
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty