MEDICARE: SOUND MIND WELLNESS SERVICES DBA SOUND MIND THERAPY

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1881544021
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUND MIND WELLNESS SERVICES DBA SOUND MIND THERAPY

Provider Business Mailing Address
First Line	:	14519 N 18TH ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33613-2417
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	14519 N 18TH ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33613-2417
Country	:	US
Telephone Number	:	727-877-0416
Fax Number	:

Authorized Official
Title or Position	:	OWNER/MANAGING MEMBER
Name	:	MISS NICOLE WHITLEY
Credential	:	LCSW
Telephone Number	:	727-877-0416

Provider Enumeration Date	:	01/28/2026
Last Update Date	:	01/28/2026

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