Healthcare Provider Details

I. General information

NPI: 1790181725
Provider Name (Legal Business Name): HEALTH PSYCH SOLUTIONS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2014
Last Update Date: 11/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13575 58TH ST N SUITE 105
CLEARWATER FL
33760-3740
US

IV. Provider business mailing address

13575 58TH ST N SUITE 105
CLEARWATER FL
33760-3740
US

V. Phone/Fax

Practice location:
  • Phone: 727-244-1379
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY6244
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW8645
License Number StateFL

VIII. Authorized Official

Name: STEPHANY WEAVER
Title or Position: PRESIDENT
Credential: LCSW
Phone: 727-244-1379