Healthcare Provider Details

I. General information

NPI: 1447120514
Provider Name (Legal Business Name): EMOTIVE WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3910 ARLINGTON DR
PALM HARBOR FL
34685-1068
US

IV. Provider business mailing address

3910 ARLINGTON DR
PALM HARBOR FL
34685-1068
US

V. Phone/Fax

Practice location:
  • Phone: 727-609-7771
  • Fax:
Mailing address:
  • Phone: 727-609-7771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER BACKER
Title or Position: CEO
Credential: LMFT
Phone: 317-507-2708