Healthcare Provider Details

I. General information

NPI: 1588653224
Provider Name (Legal Business Name): HEATHER PUGH LMHC, SAP, CAP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/15/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13575 58TH ST N
CLEARWATER FL
33760-3746
US

IV. Provider business mailing address

1150 VENETIAN HARBOR DR NE
ST PETERSBURG FL
33702-1915
US

V. Phone/Fax

Practice location:
  • Phone: 727-743-8446
  • Fax:
Mailing address:
  • Phone: 727-743-8446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCAP2119
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH6410
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: