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General NPI Number Information
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NPI Number | 1366122699
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Entity Type | Organization
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Legal Business Name | BEACH CHAIR THERAPY LLC
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Dates
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Enumeration Date | 07/21/2023
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Last Update Date | 11/05/2025
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Provider Practice Location Address
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Address Line | 3030 STARKEY BLVD
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City | NEW PORT RICHEY
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State | FL
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Zip | 34655-2175
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Country | US
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Telephone | 727-375-1140
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Fax |
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Provider Business Mailing Address
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Address Line | 9033 CALLAWAY DR
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City | TRINITY
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State | FL
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Zip | 34655-4614
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Country | US
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Telephone | 317-697-7207
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Fax |
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Authorized Official
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Title or Position | PRINCIPAL/OWNER
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Name | ANDREA HERN
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Credential | MA, LMHC
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Telephone | 317-697-7207
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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 |
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License Number State |
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