Healthcare Provider Details

I. General information

NPI: 1417866286
Provider Name (Legal Business Name): SONO BEHAVIORAL HEALTH CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7015 N ARMENIA AVE
TAMPA FL
33604-5252
US

IV. Provider business mailing address

7015 N ARMENIA AVE
TAMPA FL
33604-5252
US

V. Phone/Fax

Practice location:
  • Phone: 206-492-0723
  • Fax:
Mailing address:
  • Phone: 206-492-0723
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MS. JACQUELINE PORTER
Title or Position: MANAGING MEMBER
Credential:
Phone: 206-492-0723