Provider Demographics
NPI:1851173199
Name:MY TRIBE COUNSELING AND COACHING SERVICES LLC
Entity Type:Organization
Organization Name:MY TRIBE COUNSELING AND COACHING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:CHANELLE
Authorized Official - Last Name:MCPHATTER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:813-510-0572
Mailing Address - Street 1:5510 RIVER RD STE 207
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34652-3756
Mailing Address - Country:US
Mailing Address - Phone:813-510-0572
Mailing Address - Fax:
Practice Address - Street 1:5510 RIVER RD STE 207
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-3756
Practice Address - Country:US
Practice Address - Phone:813-510-0572
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-20
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty