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General NPI Number Information
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NPI Number | 1801765680
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Entity Type | Organization
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Legal Business Name | CEREBRUM INNOVATIONS LLC
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Dates
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Enumeration Date | 10/31/2025
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Last Update Date | 10/31/2025
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Provider Practice Location Address
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Address Line | 2474 RUMBA CT APT 3
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City | TALLAHASSEE
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State | FL
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Zip | 32304-1521
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Country | US
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Telephone | 352-810-9365
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Fax | 352-450-3091
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Provider Business Mailing Address
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Address Line | 5005 W LAUREL ST STE 100-2015
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City | TAMPA
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State | FL
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Zip | 33607-3886
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Country | US
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Telephone | 352-810-9365
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Fax | 352-450-3091
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Authorized Official
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Title or Position | OWNER
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Name | MS. KENDRA TALLEY
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Credential | LMHC
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Telephone | 352-810-9365
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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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