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General NPI Number Information
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NPI Number | 1124933239
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Entity Type | Organization
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Legal Business Name | THE COMMON GROUNDS BEHAVIORAL HEALTH, INC.
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Dates
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Enumeration Date | 08/14/2026
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Last Update Date | 08/14/2026
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Provider Practice Location Address
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Address Line | 7901 4TH ST N STE 300
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City | ST PETERSBURG
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State | FL
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Zip | 33702-4399
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Country | US
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Telephone | 850-728-7007
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Fax |
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Provider Business Mailing Address
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Address Line | 1700 N MONROE ST STE 11-142
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City | TALLAHASSEE
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State | FL
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Zip | 32303-5535
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Country | US
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Telephone | 850-728-7007
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | KHADIJAH ALI
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Credential | CBHCMS
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Telephone | 850-728-7007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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