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NPI Code Detail

MEDICARE: MIND AND MUSCLE COUNSELING LLC

MEDICARE: MIND AND MUSCLE COUNSELING 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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1497693030
Entity Type Code : Organization
Provider Name (Legal Business Name) : MIND AND MUSCLE COUNSELING LLC
Provider Business Mailing Address
First Line : 1032 E BRANDON BLVD # 4578
Second Line :
City : BRANDON
State : FL
Zip : 33511-5509
Country : US
Telephone Number : 727-537-0032
Fax Number :
Provider Business Practice Location Address
First Line : 34125 US HIGHWAY 19 N STE 200
Second Line :
City : PALM HARBOR
State : FL
Zip : 34684-2115
Country : US
Telephone Number : 727-537-0032
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : MS. KRYSTEN HAFNER
Credential : MS, LMHC, NCC
Telephone Number : 402-740-4578
Provider Enumeration Date : 03/24/2026
Last Update Date : 03/24/2026

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Directions to “MIND AND MUSCLE COUNSELING LLC ” Practice Location

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