Provider Demographics
NPI:1467066233
Name:SAMANTHA TUBBS-CREWS, LMHC
Entity Type:Organization
Organization Name:SAMANTHA TUBBS-CREWS, LMHC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:TUBBS-CREWS
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:813-281-8955
Mailing Address - Street 1:1211 N. WESTSHORE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607
Mailing Address - Country:US
Mailing Address - Phone:813-281-8955
Mailing Address - Fax:
Practice Address - Street 1:1211 N WEST SHORE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-4601
Practice Address - Country:US
Practice Address - Phone:813-281-8955
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-31
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty