MEDICARE: INFINITY COUNSELING AND CONSULTANTS LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101Y00000X	Counselor
2	101YP2500X	Professional Counselor
3	251B00000X	Case Management Agency
4	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1790521755
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INFINITY COUNSELING AND CONSULTANTS LLC

Provider Business Mailing Address
First Line	:	6015 W HANNA AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33634-5138
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6015 W HANNA AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33634-5138
Country	:	US
Telephone Number	:	321-746-5386
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CALVIN PONDS
Credential	:
Telephone Number	:	321-746-5386

Provider Enumeration Date	:	07/08/2024
Last Update Date	:	07/16/2024

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