Organization
THERANOVA COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN TAYLOR LCSW (DIRECTOR)
(813) 401-5961
Entity
Organization
Contact information
Practice address
5118 N 56TH ST STE 111, TAMPA, FL 33610-5440
(813) 401-5961
Mailing address
2001 GREGORY DR, TAMPA, FL 33613-2542
(813) 401-5961
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
03/01/2022
Last updated
03/01/2022
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