Healthcare Provider Details

I. General information

NPI: 1093710303
Provider Name (Legal Business Name): TYKES & TEENS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2005
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 SE OCEAN BLVD
STUART FL
34994-3502
US

IV. Provider business mailing address

900 SE OCEAN BLVD
STUART FL
34994-2471
US

V. Phone/Fax

Practice location:
  • Phone: 772-220-3439
  • Fax: 772-220-3484
Mailing address:
  • Phone: 772-220-3439
  • Fax: 772-220-3484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number15-43-AD-0899-00
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberARNP9469081
License Number StateFL
# 7
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: RACHEL SWEIKERT
Title or Position: BILLING & CREDENTIALING SPECIALIST
Credential:
Phone: 772-220-3439