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Organization
GET PSYCHED BEHAVIORAL HEALTH SERVICES
Active
Organization
GET PSYCHED BEHAVIORAL HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JACQUELINE ANNE GIBB M.S. (PRESIDENT)
(813) 360-3569
Entity
Organization
Contact information
Practice address
4929 VAN DYKE RD, LUTZ, FL 33558-4813
(813) 360-3569
Mailing address
15210 AMBERLY DRIVE, #625, TAMPA, FL 33647
(813) 360-3569
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
12739
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12739
REGISTERED MENTAL HEALTH INTERN
FL
Enumeration date
05/24/2017
Last updated
06/16/2018
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