Active NPI
Courtney Tiner
- Mental Health Counselor
- Clearwater, FL
National Provider Identifier
1346704822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- IMH15473
- Practice address
- 2750 N McMullen Booth Rd Ste 102E
Clearwater, FL 33761-3362 - Phone
- (770) 253-8614
- NPI assigned
- Jan 29, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | IMH15473 | FL | Primary |
Addresses
Primary practice location
2750 N McMullen Booth Rd Ste 102E
Clearwater, FL 33761-3362
Mailing address
709 Shore Dr E
Oldsmar, FL 34677-4305
Phone (770) 253-8614
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMH15473 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548720000000",
"number": "1346704822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "709 SHORE DR E",
"city": "OLDSMAR",
"state": "FL",
"postal_code": "346774305",
"telephone_number": "770-253-8614"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2750 N MCMULLEN BOOTH RD STE 102E",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337613362",
"telephone_number": "770-253-8614"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TINER",
"first_name": "COURTNEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-29",
"last_updated": "2019-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "IMH15473",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clearwater, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.