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General NPI Number Information
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NPI Number | 1003392853
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Entity Type | Organization
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Legal Business Name | SOUND MIND COUNSELING
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Dates
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Enumeration Date | 07/16/2018
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Last Update Date | 07/16/2018
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Provider Practice Location Address
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Address Line | 2708 ALT 19 STE 507-10
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City | PALM HARBOR
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State | FL
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Zip | 34683-2665
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Country | US
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Telephone | 727-657-8833
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Fax | 727-754-4230
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Provider Business Mailing Address
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Address Line | 1552 SUNRAY DR
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City | PALM HARBOR
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State | FL
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Zip | 34683-3962
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Country | US
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Telephone | 727-657-8833
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NICOLE MAUREEN STRATIS KRATIMENOS
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Credential | LMHC
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Telephone | 727-657-8833
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH9774
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License Number State | FL
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