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General NPI Number Information
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NPI Number | 1841119096
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Entity Type | Organization
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Legal Business Name | OUR MOSAIC LLC
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Dates
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Enumeration Date | 07/13/2026
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Last Update Date | 07/13/2026
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Provider Practice Location Address
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Address Line | 7901 4TH ST N STE 27212
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City | ST PETERSBURG
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State | FL
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Zip | 33702-4399
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Country | US
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Telephone | 954-997-7175
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Fax | 954-405-8905
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Provider Business Mailing Address
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Address Line | 18331 PINES BLVD # 175
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City | PEMBROKE PINES
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State | FL
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Zip | 33029-1421
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Country | US
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Telephone | 954-997-7175
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Fax | 954-405-8905
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Authorized Official
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Title or Position | OWNER/PRIMARY THERAPIST
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Name | GENIELLE BURROWS
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Credential | LMHC, NCC
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Telephone | 954-610-2280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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