Individual provider Active NPI

Antoinette M Hagley, MH, MT.

  • Marriage & Family Therapist
  • Tampa, FL
National Provider Identifier
1396936720
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MT2140 Issued in FL
Practice address
5707 N 22ND St
Tampa, FL 33610-4350
Phone
(813) 384-4000
NPI assigned
Aug 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MT2140 FL Primary
Counselor 101Y00000X MH 8480 FL

Addresses

Primary practice location

5707 N 22ND St
Tampa, FL 33610-4350

Mailing address

4422 E Columbus Dr
Tampa, FL 33605-3233
Phone (813) 384-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251117001416 FL Practitioner - Mental Health Counselor 7517324361 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5707 - N 22ND St
Tampa, FL 33610-4350

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Medical Technician

State licenses

LicenseStateTypeSpecialty
MH 8480FLMDCounselor
MT2140FLMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ibis Healthcare Inc CurrentSince Oct 10, 2025 Accepting new patients
Ibis Healthcare Inc CurrentSince Oct 10, 2025 Accepting new patients

Locations

5707 N 22nd St
Tampa, FL 33610
Phone (813) 272-2244

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1186617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1396936720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4422 E COLUMBUS DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336053233",
            "telephone_number": "813-384-4000",
            "fax_number": "813-514-8281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5707 N 22ND ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336104350",
            "telephone_number": "813-384-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGLEY",
        "first_name": "ANTOINETTE",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "MH, MT.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-09",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT2140",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "FL",
            "license": "MH 8480",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.