Healthcare Provider Details

I. General information

NPI: 1386947596
Provider Name (Legal Business Name): ELIZABETH MAUST LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2010
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5474 77TH AVE N
PINELLAS PARK FL
33781-3345
US

IV. Provider business mailing address

5474 77TH AVE N
PINELLAS PARK FL
33781-3345
US

V. Phone/Fax

Practice location:
  • Phone: 813-476-2108
  • Fax:
Mailing address:
  • Phone: 813-476-2108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH10125
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: