Provider Demographics
NPI:1821445792
Name:TRANQUILITY COUNSELING LLC
Entity Type:Organization
Organization Name:TRANQUILITY COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:BOTELHO
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:727-365-9365
Mailing Address - Street 1:801 W BAY DR STE 425
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33770-3223
Mailing Address - Country:US
Mailing Address - Phone:727-365-9365
Mailing Address - Fax:844-773-9456
Practice Address - Street 1:801 W BAY DR STE 425
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33770-3223
Practice Address - Country:US
Practice Address - Phone:727-365-9365
Practice Address - Fax:844-773-9456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-19
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH11858101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty