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Transformative Healthcare Solutions West LLC

Organization Active NPI Clinical Psychologist · Tampa, FL

NPI 1700610508 · NPPES record last updated Aug 27, 2024

Key facts

NPI
1700610508
Entity type
Organization (NPI type 2)
Primary specialty
Clinical Psychologist 103TC0700X
Legal business name
TRANSFORMATIVE HEALTHCARE SOLUTIONS WEST LLC
Practice address
4820 W Gandy Blvd
Tampa, FL 33611-3003
Phone
(954) 885-9500
Fax
(954) 885-9444
NPI assigned
Aug 26, 2024
Organization subpart
No

Authorized official

Name
Ann Monis NPI 1972887412
Title
President
Phone
(954) 885-9500

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

Practitioners 44

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

View all 44

Medicare participation

Medicare fee-for-service enrollment
Enrolled in FL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20250326004137 FL Part B Supplier - Clinic/Group Practice 6103349568 Receives reassigned benefits from 44 practitioners

National Provider Directory

Locations

6439 1st Ave S
St Petersburg, FL 33707
Phone (727) 343-6944

11722 N 17th St
Tampa, FL 33612
Phone (813) 971-8032

4820 W Gandy Blvd
Tampa, FL 33611

200 Nassau St N
Venice, FL 34285
Phone (305) 397-8417

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor
Group: 193200000X MULTI-SPECIALTY GROUP		 101YM0800X
Clinical Psychologist
Group: 193200000X MULTI-SPECIALTY GROUP		 103TC0700X Yes
Clinical Social Worker
Group: 193200000X MULTI-SPECIALTY GROUP		 1041C0700X
Marriage & Family Therapist
Group: 193200000X MULTI-SPECIALTY GROUP		 106H00000X
Psychiatric/Mental Health Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP		 363LP0808X

Addresses

Primary practice location

4820 W Gandy Blvd
Tampa, FL 33611-3003

Mailing address

1848 SE 1St Ave
Fort Lauderdale, FL 33316-2875
Phone (954) 885-9500

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 27, 2024.

{
    "created_epoch": "1724630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724716800000",
    "number": "1700610508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1848 SE 1ST AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162875",
            "telephone_number": "954-885-9500",
            "fax_number": "954-885-9444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4820 W GANDY BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336113003",
            "telephone_number": "954-885-9500",
            "fax_number": "954-885-9444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRANSFORMATIVE HEALTHCARE SOLUTIONS WEST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-26",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A",
        "authorized_official_last_name": "MONIS",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-885-9500"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

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Sources for this page

Verify at the official NPI Registry.