| Gulfcoast Psychotherapy | |
|
5348 1st Ave N St Petersburg FL 33710-8106 | |
| (727) 322-6123 | |
| (727) 322-6143 |
| Full Name | Gulfcoast Psychotherapy |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 5348 1st Ave N, St Petersburg, Florida |
| Authorized Official Name and Position | Tania Mings (BILLING REP) |
| Authorized Official Contact | 4078393006 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gulfcoast Psychotherapy Po Box 47918 St Petersburg FL 33743-7918 Ph: (727) 322-6123 | Gulfcoast Psychotherapy 5348 1st Ave N St Petersburg FL 33710-8106 Ph: (727) 322-6123 |
| NPI Number | 1932368479 |
|---|---|
| Provider Enumeration Date | 06/09/2008 |
| Last Update Date | 11/24/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932368479 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY5607 (Florida) | Primary |
| 103TC0700X | Psychologist - Clinical | PY6690 (Florida) | Secondary |
| 104100000X | Social Worker | SW4402 (Florida) | Secondary |
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