Healthcare Provider Details

I. General information

NPI: 1043909807
Provider Name (Legal Business Name): COMPLETE PRACTICE SOLUTIONS AND CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2023
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 S BRONOUGH ST
TALLAHASSEE FL
32301-1705
US

IV. Provider business mailing address

214 S BRONOUGH ST
TALLAHASSEE FL
32301-1705
US

V. Phone/Fax

Practice location:
  • Phone: 850-448-1477
  • Fax: 850-448-1488
Mailing address:
  • Phone: 850-448-1477
  • Fax: 850-448-1488

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 Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MS. CARISSA SHEPPARD-STUMPF
Title or Position: OWNER
Credential:
Phone: 850-901-8994