Healthcare Provider Details

I. General information

NPI: 1780351734
Provider Name (Legal Business Name): THERAPYCENTRAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2021
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7901 4TH ST N STE 8156
ST PETERSBURG FL
33702-4305
US

IV. Provider business mailing address

79 OGLE RD
OLD TAPPAN NJ
07675-7026
US

V. Phone/Fax

Practice location:
  • Phone: 732-485-1301
  • Fax: 727-810-3750
Mailing address:
  • Phone: 732-485-1301
  • Fax: 888-491-6463

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: YASIR AHMAD
Title or Position: OWNER
Credential: MD
Phone: 732-485-1301