Healthcare Provider Details

I. General information

NPI: 1962363010
Provider Name (Legal Business Name): CENTER FOR PARENT COACHING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2025
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1130 TUXFORD DR
BRANDON FL
33511-8300
US

IV. Provider business mailing address

1130 TUXFORD DR
BRANDON FL
33511-8300
US

V. Phone/Fax

Practice location:
  • Phone: 813-545-9505
  • Fax:
Mailing address:
  • Phone: 813-545-9505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MAXINE L GOLDEN
Title or Position: OWNER
Credential: MFT
Phone: 813-545-9505