MEDICARE: EMOTIVE WELLNESS CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1447120514
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMOTIVE WELLNESS CENTER

Provider Business Mailing Address
First Line	:	3910 ARLINGTON DR
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34685-1068
Country	:	US
Telephone Number	:	727-609-7771
Fax Number	:

Provider Business Practice Location Address
First Line	:	3910 ARLINGTON DR
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34685-1068
Country	:	US
Telephone Number	:	727-609-7771
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	CHRISTOPHER BACKER
Credential	:	LMFT
Telephone Number	:	317-507-2708

Provider Enumeration Date	:	11/05/2025
Last Update Date	:	12/10/2025

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Directions to “EMOTIVE WELLNESS CENTER ” Practice Location

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