Healthcare Provider Details

I. General information

NPI: 1841154259
Provider Name (Legal Business Name): ALICIA BRATHWAITE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13000 BRUCE B DOWNS BLVD
TAMPA FL
33612-4745
US

IV. Provider business mailing address

13000 BRUCE B DOWNS BLVD
TAMPA FL
33612-4745
US

V. Phone/Fax

Practice location:
  • Phone: 813-972-2000
  • Fax:
Mailing address:
  • Phone: 813-972-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number004890
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: