Organization
R.E.S.E.T. COUNSELING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIJUAN MALCOLM GRIMES LMHC (LICENSE MENTAL HEALTH COUNSELOR)
(201) 503-5642
Entity
Organization
Contact information
Practice address
1806 E HANNA AVE, TAMPA, FL 33610-3543
(201) 503-5642
Mailing address
1806 E HANNA AVE, TAMPA, FL 33610-3543
(201) 503-5642
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
08/28/2020
Last updated
08/28/2020
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