Organization
SOUTH BAY COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN ANDREW BELL LCSW (OWNER/MANAGER)
(727) 698-0624
Entity
Organization
Contact information
Practice address
5995 DR MARTIN LUTHER KING JR ST S, SAINT PETERSBURG, FL 33705-5541
(727) 698-0624
(727) 867-2556
Mailing address
5995 DR MARTIN LUTHER KING JR ST S, SAINT PETERSBURG, FL 33705-5541
(727) 698-0624
(727) 867-2556
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SW6542
STATE LICENSE
FL
Enumeration date
09/01/2020
Last updated
09/01/2020
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