Provider Demographics
NPI:1942008198
Name:TEA TIME THERAPY LLC
Entity type:Organization
Organization Name:TEA TIME THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLAIR
Authorized Official - Middle Name:
Authorized Official - Last Name:SPORTSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:907-921-7380
Mailing Address - Street 1:PO BOX 7237
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-0103
Mailing Address - Country:US
Mailing Address - Phone:907-921-7380
Mailing Address - Fax:
Practice Address - Street 1:205 E BENSON BLVD
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-4019
Practice Address - Country:US
Practice Address - Phone:907-921-7380
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty