| Tampa Bay Area Counseling | |
|
16502 N Dale Mabry Hwy Tampa FL 33618-1325 | |
| (727) 732-4305 | |
| Not Available |
| Full Name | Tampa Bay Area Counseling |
|---|---|
| Speciality | Clinic/Center |
| Location | 16502 N Dale Mabry Hwy, Tampa, Florida |
| Authorized Official Name and Position | Charisse Diaz (CEO) |
| Authorized Official Contact | 8136010595 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tampa Bay Area Counseling 2868 Living Coral Dr Odessa FL 33556-5123 Ph: (813) 601-0595 | Tampa Bay Area Counseling 16502 N Dale Mabry Hwy Tampa FL 33618-1325 Ph: (727) 732-4305 |
| NPI Number | 1508409319 |
|---|---|
| Provider Enumeration Date | 10/24/2019 |
| Last Update Date | 08/22/2023 |
| Certification Date | 08/21/2023 |
| Medicare PECOS PAC ID | 5193176006 |
|---|---|
| Medicare Enrollment ID | O20240104002928 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508409319 | NPI | - | NPPES |
| Provider Name | William P Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679084958 PECOS PAC ID: 1153761051 Enrollment ID: I20240430000948 |
| Provider Name | Charisse Diaz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295144699 PECOS PAC ID: 7012285265 Enrollment ID: I20240430001899 |
| Provider Name | Lauren Roberts |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073139085 PECOS PAC ID: 2264872985 Enrollment ID: I20240430002646 |
| Provider Name | Emanuel Diaz Rosa |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306433107 PECOS PAC ID: 7113366519 Enrollment ID: I20240509001098 |
| Provider Name | Holly Gardner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1508563206 PECOS PAC ID: 0143755181 Enrollment ID: I20241127001172 |
| Provider Name | Kada Stull |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710448402 PECOS PAC ID: 9830619139 Enrollment ID: I20250217002496 |
| Provider Name | Omodele Cordero |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699349910 PECOS PAC ID: 2062932320 Enrollment ID: I20250218001224 |
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