MEDICARE: OHANA COUNSELING SERVICES

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101Y00000X	Counselor
2	101YA0400X	Addiction (Substance Use Disorder) Counselor
3	101YM0800X	Mental Health Counselor
4	106H00000X	Marriage & Family Therapist
5	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1932716040
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OHANA COUNSELING SERVICES

Provider Business Mailing Address
First Line	:	22311 RIVER ROCK DR
Second Line	:
City	:	LAND O LAKES
State	:	FL
Zip	:	34639-4632
Country	:	US
Telephone Number	:	813-817-7379
Fax Number	:

Provider Business Practice Location Address
First Line	:	13902 N DALE MABRY HWY STE 240
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618-2428
Country	:	US
Telephone Number	:	813-336-1919
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ LICENSED COUNSELOR
Name	:	VANESSA MUIR
Credential	:	LMHC
Telephone Number	:	813-336-1919

Provider Enumeration Date	:	09/23/2020
Last Update Date	:	09/23/2020

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