Organization Active NPI

Raitano Enterprises, Inc.

Doing business as Flourish Psychology and Wellness

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • St Petersburg, FL
National Provider Identifier
1568127942
Registry record updated Nov 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
RAITANO ENTERPRISES, INC.
Doing business as
Flourish Psychology and Wellness
Practice address
840 Beach Dr NE
St Petersburg, FL 33701-2012
Phone
(727) 543-3235
NPI assigned
Nov 1, 2021
Last updated
Nov 1, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2021

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

Authorized official

Name
Dr. Amanda Thalji-Raitano, PH.D.NPI 1679996144
Title
Licensed Psychologist
Phone
(727) 543-3235

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

840 Beach Dr NE
St Petersburg, FL 33701-2012

Mailing address

518 33Rd Ave N
Saint Petersburg, FL 33704-1218
Phone (727) 543-3235

Other names 1

  • Flourish Psychology and Wellness Doing business as

National Provider Directory

National Provider Directory

Locations

840 Beach Dr NE
St Petersburg, FL 33701
Phone (727) 310-5520

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1635724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635724800000",
    "number": "1568127942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 33RD AVE N",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337041218",
            "telephone_number": "727-543-3235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 BEACH DR NE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337012012",
            "telephone_number": "727-543-3235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAITANO ENTERPRISES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-01",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A",
        "authorized_official_last_name": "THALJI-RAITANO",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "727-543-3235",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Flourish Psychology and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.