Healthcare Provider Details

I. General information

NPI: 1265355804
Provider Name (Legal Business Name): COMPOSURE COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4312 BELL SHOALS RD
VALRICO FL
33596-7171
US

IV. Provider business mailing address

4312 BELL SHOALS RD
VALRICO FL
33596-7171
US

V. Phone/Fax

Practice location:
  • Phone: 813-934-6460
  • Fax: 813-280-5444
Mailing address:
  • Phone: 813-934-6460
  • Fax: 813-280-5444

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: JAYME LEIGH CHAMBERS
Title or Position: LICENSED MENTAL HEALTH COUNSELOR
Credential: LMHC, NCC
Phone: 813-934-6460