| Shifting Tides Therapy Lmsw, Pllc | |
|
555 Dr Mlk Jr St S Unit 405 Saint Petersburg FL 33705 | |
| (781) 664-0647 | |
| Not Available |
| Full Name | Shifting Tides Therapy Lmsw, Pllc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 555 Dr Mlk Jr St S, Saint Petersburg, Florida |
| Authorized Official Name and Position | Deanna Doherty (OWNER) |
| Authorized Official Contact | 7816640647 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shifting Tides Therapy Lmsw, Pllc 767 Broadway #1327 Manhattan NY 10003 Ph: (781) 664-0647 | Shifting Tides Therapy Lmsw, Pllc 555 Dr Mlk Jr St S Unit 405 Saint Petersburg FL 33705 Ph: (781) 664-0647 |
| NPI Number | 1114762788 |
|---|---|
| Provider Enumeration Date | 06/26/2024 |
| Last Update Date | 06/26/2024 |
| Certification Date | 06/18/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114762788 | NPI | - | NPPES |
| 1336780295 | Other | NY | MY PERSONAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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