Healthy Lifestyles Tampa Bay LLC

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

PY7593 Issued in FL

Legal business name

HEALTHY LIFESTYLES TAMPA BAY LLC

Practice address

8479 Dr Martin Luther King Jr St N
St Petersburg, FL 33702

Phone

(727) 906-6185

Fax

(866) 352-2359

NPI assigned

Jan 17, 2018

Last updated

Jun 26, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Thomas G Quinlan, PSY.DNPI 1356539837

Title

Owner

Phone

(727) 906-6185

Specialties & licenses 1

Addresses

Other identifiers 2

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.

• Thomas Grant Quinlan, PSY.D.

  • Adult Development & Aging Psychologist
  • St Petersburg, FL
  • NPI 1356539837
  Authorized official Same address or phone

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

{
    "created_epoch": "1516147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529971200000",
    "number": "1891203485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8479 DR MARTIN LUTHER KING JR ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337023503",
            "telephone_number": "727-906-6185",
            "fax_number": "866-352-2359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8479 DR MARTIN LUTHER KING JR ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "33702",
            "telephone_number": "727-906-6185",
            "fax_number": "866-352-2359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY LIFESTYLES TAMPA BAY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-17",
        "last_updated": "2018-06-26",
        "status": "A",
        "authorized_official_last_name": "QUINLAN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-906-6185",
        "authorized_official_credential": "PSY.D"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "FL",
            "license": "PY7593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSE",
            "identifier": "PY7593",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PY7593",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Counseling Psychologist in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Counseling Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2018; 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.