Provider Demographics
NPI:1295362390
Name:TALK2ME UNCONVENTIONAL THERAPY
Entity Type:Organization
Organization Name:TALK2ME UNCONVENTIONAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:MANNINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:813-260-5949
Mailing Address - Street 1:6355 SHORE VISTA PL
Mailing Address - Street 2:
Mailing Address - City:APOLLO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33572-1575
Mailing Address - Country:US
Mailing Address - Phone:813-260-5949
Mailing Address - Fax:
Practice Address - Street 1:6355 SHORE VISTA PL
Practice Address - Street 2:
Practice Address - City:APOLLO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33572-1575
Practice Address - Country:US
Practice Address - Phone:813-260-5949
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-26
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty