MEDICARE: INCLUSIVE BEHAVIORAL HEALTH, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1336072644
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INCLUSIVE BEHAVIORAL HEALTH, LLC

Provider Business Mailing Address
First Line	:	2301 DR. MLK STREET SOUTH
Second Line	:	#1010
City	:	ST. PETERSBURG
State	:	FL
Zip	:	33705
Country	:	US
Telephone Number	:	813-773-5939
Fax Number	:

Provider Business Practice Location Address
First Line	:	495 38TH AVE N
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33704-1333
Country	:	US
Telephone Number	:	813-773-5939
Fax Number	:

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	RENEE OSBORNE
Credential	:	LCSW
Telephone Number	:	813-773-5939

Provider Enumeration Date	:	06/05/2026
Last Update Date	:	06/05/2026

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