Healthcare Provider Details

I. General information

NPI: 1124957238
Provider Name (Legal Business Name): ADAPTIVE HEALTH PSYCHOLOGY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3110 GRAND AVE APT 2411
PINELLAS PARK FL
33782
US

IV. Provider business mailing address

690 MAIN ST # 772
SAFETY HARBOR FL
34695-3551
US

V. Phone/Fax

Practice location:
  • Phone: 727-607-5553
  • Fax:
Mailing address:
  • Phone: 727-607-5553
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JULIA JOHNSTON
Title or Position: CLINICAL PSYCHOLOGIST/ OWNER
Credential: PHD
Phone: 727-607-5553