NPIMap

Organization Active NPI

My Therapist Julie, Inc.

  • Counselor
  • Tampa, FL
National Provider Identifier
1750832069
Registry record updated Oct 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
MH11025 Issued in FL
Legal business name
MY THERAPIST JULIE, INC.
Practice address
3825 Henderson Blvd
Suite 405
Tampa, FL 33629-5037
Phone
(813) 858-7663
Fax
(239) 307-2395
NPI assigned
Oct 21, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2016

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

Authorized official

Name
Julie Goddard Martin, LMHC
Title
President
Phone
(813) 858-7663

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101Y00000X MH11025 FL Primary

Addresses

Primary practice location

3825 Henderson Blvd
Suite 405
Tampa, FL 33629-5037

Mailing address

1710 W Fore Dr
Tampa, FL 33612-5022
Phone (813) 858-7663

National Provider Directory

National Provider Directory

Locations

3825 Henderson Blvd
Ste 405
Tampa, FL 33629
Phone (813) 421-3435

NPI Registry JSON

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

{
    "created_epoch": "1477008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477008000000",
    "number": "1750832069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 W FORE DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336125022",
            "telephone_number": "813-858-7663",
            "fax_number": "239-307-2395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3825 HENDERSON BLVD",
            "address_2": "SUITE 405",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336295037",
            "telephone_number": "813-858-7663",
            "fax_number": "239-307-2395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY THERAPIST JULIE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-21",
        "last_updated": "2016-10-21",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "GODDARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-858-7663",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": "FL",
            "license": "MH11025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2016; 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.