Provider Demographics
NPI:1578987103
Name:SUAREZ, TINA MARIE (LMHC)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:MARIE
Last Name:SUAREZ
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:TINA
Other - Middle Name:MARIE
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:27251 WESLEY CHAPEL BLVD STE 310
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-4285
Mailing Address - Country:US
Mailing Address - Phone:813-591-0468
Mailing Address - Fax:
Practice Address - Street 1:7549 STONEBROOK CIR
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33545-2216
Practice Address - Country:US
Practice Address - Phone:813-591-0468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-18
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH10587101YM0800X
FLMH13752101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health