Healthcare Provider Details

I. General information

NPI: 1497789424
Provider Name (Legal Business Name): PSYCH 2 U PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7945 1ST AVE S
ST PETERSBURG FL
33707-1019
US

IV. Provider business mailing address

7945 1ST AVE S
ST PETERSBURG FL
33707-1019
US

V. Phone/Fax

Practice location:
  • Phone: 727-214-7079
  • Fax: 954-245-3143
Mailing address:
  • Phone: 727-214-7079
  • Fax: 954-245-3143

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number3027792
License Number StateFL

VIII. Authorized Official

Name: REBA ELAINE SHOENFELT
Title or Position: MEMBER MANAGER
Credential: ARNP
Phone: 727-214-7079