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General NPI Number Information
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NPI Number | 1790253508
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Entity Type | Organization
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Legal Business Name | BEHAVIORAL HEALTH OF SOUTH TAMPA
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Dates
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Enumeration Date | 11/09/2018
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Last Update Date | 11/09/2018
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Provider Practice Location Address
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Address Line | 902 N ARMENIA AVE
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City | TAMPA
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State | FL
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Zip | 33609-1707
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Country | US
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Telephone |
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Fax |
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Provider Business Mailing Address
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Address Line | 902 N ARMENIA AVE
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City | TAMPA
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State | FL
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Zip | 33609-1707
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Country | US
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Telephone | 813-758-3754
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Fax | 813-879-2610
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Authorized Official
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Title or Position | OWNER/CLINICAL PSYCHOLOGIST
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Name | DR. JENNIFER BARROR-LEVINE
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Credential | PSY.D.
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Telephone | 813-758-3754
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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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