Healthcare Provider Details

I. General information

NPI: 1134705270
Provider Name (Legal Business Name): MICHELE MESSINA LSP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2021
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2727 ULMERTON RD STE 210
CLEARWATER FL
33762-3369
US

IV. Provider business mailing address

2727 ULMERTON RD STE 210
CLEARWATER FL
33762-3369
US

V. Phone/Fax

Practice location:
  • Phone: 941-248-7330
  • Fax:
Mailing address:
  • Phone: 941-445-2323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH28140
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number1511
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: