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General NPI Number Information
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NPI Number | 1366690422
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Entity Type | Organization
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Legal Business Name | BEHAVIORAL CONSULTING OF TAMPA BAY
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Dates
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Enumeration Date | 09/03/2008
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Last Update Date | 11/15/2024
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Provider Practice Location Address
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Address Line | 14497 N. DALE MABRY STE 115-N
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City | TAMPA
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State | FL
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Zip | 33618
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Country | US
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Telephone | 813-814-2000
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Fax | 813-814-2004
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Provider Business Mailing Address
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Address Line | 14497 N. DALE MABRY STE 115-N
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City | TAMPA
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State | FL
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Zip | 33618
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Country | US
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Telephone | 813-814-2000
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Fax | 813-814-2004
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | NIKKI BENNETT
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Credential |
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Telephone | 813-814-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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