Organization Active NPI

Counseling & Wellness Boutique LLC

  • Clinical Social Worker
  • Tampa, FL
National Provider Identifier
1992294375
Registry record updated Aug 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
COUNSELING & WELLNESS BOUTIQUE LLC
Practice address
1503 S US Highway 301 Ste E16
Tampa, FL 33619-5126
Phone
(813) 591-4868
Fax
(813) 279-2551
NPI assigned
May 1, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2019

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

Authorized official

Name
Mrs. Taina Thorpe, LCSW
Title
Clinical Director
Phone
(813) 591-4868

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

1503 S US Highway 301 Ste E16
Tampa, FL 33619-5126

Mailing address

11705 Boyette Rd # 248
Riverview, FL 33569-5533
Phone (813) 591-4868

National Provider Directory

National Provider Directory

Locations

1936 W Mlk Blvd
Ste 218
Tampa, FL 33607
Phone (813) 591-4868

1503 S US Highway 301
Ste E16
Tampa, FL 33619
Phone (813) 586-3106

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1525132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567123200000",
    "number": "1992294375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11705 BOYETTE RD # 248",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335695533",
            "telephone_number": "813-591-4868",
            "fax_number": "813-279-2551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1503 S US HIGHWAY 301 STE E16",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336195126",
            "telephone_number": "813-591-4868",
            "fax_number": "813-279-2551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNSELING & WELLNESS BOUTIQUE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-01",
        "last_updated": "2019-08-30",
        "status": "A",
        "authorized_official_last_name": "THORPE",
        "authorized_official_first_name": "TAINA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "813-591-4868",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "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 Aug 30, 2019; 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.