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General NPI Number Information
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NPI Number | 1043088677
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Entity Type | Organization
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Legal Business Name | SUPPORT YOU MENTAL WELLNESS
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Dates
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Enumeration Date | 12/13/2023
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Last Update Date | 12/13/2023
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Provider Practice Location Address
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Address Line | 4830 W KENNEDY BLVD STE 600
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City | TAMPA
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State | FL
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Zip | 33609-2584
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Country | US
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Telephone | 727-410-5818
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Fax |
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Provider Business Mailing Address
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Address Line | 6421 N FLORIDA AVE # D-1942
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City | TAMPA
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State | FL
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Zip | 33604-6007
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Country | US
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Telephone | 727-410-5818
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Fax |
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Authorized Official
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Title or Position | CEO,SPEAKER/THERAPIST
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Name | ANNIELLE TIMMONS
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Credential | LCSW
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Telephone | 727-410-5818
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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