Tiny Rebellion LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

TINY REBELLION LLC

Practice address

7205 64TH Way N
Pinellas Park, FL 33781-4027

Phone

(970) 784-0255

NPI assigned

Jun 26, 2026

Organization subpart

No

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

Authorized official

Name

Mr. Mike Johnson

Title

Manager

Phone

(970) 784-0255

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1782432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782432000000",
    "number": "1619893377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7205 64TH WAY N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337814027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7205 64TH WAY N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337814027",
            "telephone_number": "970-784-0255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TINY REBELLION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-26",
        "last_updated": "2026-06-26",
        "certification_date": "2026-06-26",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "970-784-0255",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2026; 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.