Healthcare Provider Details

I. General information

NPI: 1851226435
Provider Name (Legal Business Name): JOSEPH ASSOULINE, PSYD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8130 66TH ST N STE 10
PINELLAS PARK FL
33781-2111
US

IV. Provider business mailing address

7901 4TH ST N STE 300
SAINT PETERSBURG FL
33702-4399
US

V. Phone/Fax

Practice location:
  • Phone: 813-906-9810
  • Fax:
Mailing address:
  • Phone: 813-906-9810
  • 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 Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH ASSOULINE
Title or Position: OWNER
Credential: PSYD
Phone: 813-906-9810