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General NPI Number Information
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NPI Number | 1699551044
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Entity Type | Organization
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Legal Business Name | ESSENTIAL CONNECTIONS THERAPY PLLC
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Dates
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Enumeration Date | 09/01/2023
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Last Update Date | 09/01/2023
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Provider Practice Location Address
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Address Line | 16120 N FLORIDA AVE
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City | LUTZ
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State | FL
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Zip | 33549-6129
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Country | US
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Telephone | 813-598-4332
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Fax |
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Provider Business Mailing Address
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Address Line | 2780 E FOWLER AVE STE 428
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City | TAMPA
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State | FL
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Zip | 33612-6297
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Country | US
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Telephone | 813-598-4332
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | KIMBERLY ANN FIELDING-MADDISON
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Credential | LMFT, LMHC, CRC
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Telephone | 813-509-4332
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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