Healthcare Provider Details

I. General information

NPI: 1811722473
Provider Name (Legal Business Name): COMPLETE THERAPY PINELLAS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2024
Last Update Date: 05/02/2026
Certification Date: 05/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34921 US 19 N STE 450
PALM HARBOR FL
34684-1922
US

IV. Provider business mailing address

2214 VANCE AVE
PALM HARBOR FL
34683-4943
US

V. Phone/Fax

Practice location:
  • Phone: 727-480-6669
  • Fax:
Mailing address:
  • Phone: 727-480-6669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: NICHOLE PARKER
Title or Position: THERAPIST/OWNER
Credential: MSP, LMFT
Phone: 727-480-6669