NPIMap

Organization Active NPI

Tranquility Wellness Group, LLC

  • Clinical Social Worker
  • Brandon, FL
National Provider Identifier
1003522723
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
TRANQUILITY WELLNESS GROUP, LLC
Practice address
109 N Oakwood Ave Ste 105
Brandon, FL 33510-4629
Phone
(904) 704-7575
NPI assigned
Jan 26, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Adam Booth
Title
Owner
Phone
(717) 608-0329

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

109 N Oakwood Ave Ste 105
Brandon, FL 33510-4629

Mailing address

5668 Fishhawk Crossing Blvd # 142
Lithia, FL 33547-5900
Phone (904) 704-7575

Other names 1

  • Ellie Mental Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230502001860 FL Part B Supplier - Clinic/Group Practice 1759746423 Receives reassigned benefits from 6 practitioners
Practice locations: Brandon, FL

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

  • Emerald Clover, LLC
    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • St Petersburg, FL
    • NPI 1972218055

    Member Of

    NPD member

Locations

109 N Oakwood Ave
Ste 105
Brandon, FL 33510
Phone (813) 355-0878

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1674691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749686400000",
    "number": "1003522723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5668 FISHHAWK CROSSING BLVD # 142",
            "city": "LITHIA",
            "state": "FL",
            "postal_code": "335475900",
            "telephone_number": "904-704-7575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 N OAKWOOD AVE STE 105",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335104629",
            "telephone_number": "904-704-7575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRANQUILITY WELLNESS GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-26",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A",
        "authorized_official_last_name": "BOOTH",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "717-608-0329",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ellie Mental Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ellie Mental Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.