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General NPI Number Information
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NPI Number | 1578385092
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Entity Type | Organization
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Legal Business Name | NEURODIVERGENT EMPOWERMENT INSTITUE INC
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Dates
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Enumeration Date | 10/26/2024
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Last Update Date | 03/02/2025
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Provider Practice Location Address
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Address Line | 146 2ND ST N STE 101
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City | ST PETERSBURG
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State | FL
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Zip | 33701-3361
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Country | US
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Telephone | 727-490-9911
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Fax |
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Provider Business Mailing Address
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Address Line | 146 2ND ST N STE 101
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City | ST PETERSBURG
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State | FL
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Zip | 33701-3361
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Country | US
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Telephone | 727-490-9911
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Fax |
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Authorized Official
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Title or Position | CMO
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Name | ANGELA FISHER
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Credential | PHD
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Telephone | 727-490-9911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101200000X
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Taxonomy Name | Drama Therapist
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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 | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 102X00000X
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Taxonomy Name | Poetry Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 103TH0004X
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Taxonomy Name | Health Psychologist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2084P0015X
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Taxonomy Name | Psychosomatic Medicine Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 225A00000X
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Taxonomy Name | Music Therapist
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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