Provider Demographics
NPI:1790249696
Name:THE BE CENTRE FOR MENTAL HEALTH AND WELLNESS LLC
Entity Type:Organization
Organization Name:THE BE CENTRE FOR MENTAL HEALTH AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JERMIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:813-603-7473
Mailing Address - Street 1:10312 BLOOMINGDALE AVE STE 108-172
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-3663
Mailing Address - Country:US
Mailing Address - Phone:813-603-7473
Mailing Address - Fax:
Practice Address - Street 1:10312 BLOOMINGDALE AVE STE 108-172
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-3663
Practice Address - Country:US
Practice Address - Phone:813-603-7473
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-24
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty