Organization
CATALYST CENTER FOR CHANGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT GRUPP (AUTHORIZED MEMBER)
(813) 287-9500
Entity
Organization
Contact information
Practice address
4100 W KENNEDY BLVD, SUITE 210, TAMPA, FL 33609-2288
(813) 287-9500
(813) 336-5226
Mailing address
4100 W. KENNEDY BLVD., SUITE 210, TAMPA, FL 33609
(813) 287-9500
(813) 336-5226
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
IMH14171
FL
1041C0700X
Clinical Social Worker
Primary
SW9992
FL
Other
Enumeration date
08/16/2016
Last updated
08/16/2016
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