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General NPI Number Information
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NPI Number | 1689513996
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Entity Type | Organization
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Legal Business Name | PSYCHSHIFT, LLC
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Dates
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Enumeration Date | 03/25/2026
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Last Update Date | 03/25/2026
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Provider Practice Location Address
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Address Line | 4830 W KENNEDY BLVD
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City | TAMPA
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State | FL
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Zip | 33609-2564
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Country | US
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Telephone | 304-654-7557
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Fax | 304-654-7557
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Provider Business Mailing Address
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Address Line | 454 TOWNSHIP ROAD 1329
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City | IRONTON
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State | OH
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Zip | 45638-8378
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Country | US
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Telephone | 304-654-7557
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Fax | 220-215-9005
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Authorized Official
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Title or Position | OWNER
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Name | MELANIE DANIELSON
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Credential | LICSW
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Telephone | 304-654-7557
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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