Provider Demographics
NPI:1073135307
Name:MORALES, TANIA (LMHC)
Entity Type:Individual
Prefix:
First Name:TANIA
Middle Name:
Last Name:MORALES
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2398 BREWTON AVE
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34608-4501
Mailing Address - Country:US
Mailing Address - Phone:305-984-2960
Mailing Address - Fax:
Practice Address - Street 1:2398 BREWTON AVE
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34608-4501
Practice Address - Country:US
Practice Address - Phone:305-984-2960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-08
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL17927101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health