Provider Demographics
NPI:1861847477
Name:MOTHERING CENTER LLC
Entity Type:Organization
Organization Name:MOTHERING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:MAIER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:813-431-0797
Mailing Address - Street 1:300 S HYDE PARK AVE
Mailing Address - Street 2:SUITE 250
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-2286
Mailing Address - Country:US
Mailing Address - Phone:813-431-0797
Mailing Address - Fax:
Practice Address - Street 1:300 S HYDE PARK AVE
Practice Address - Street 2:SUITE 250
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-2286
Practice Address - Country:US
Practice Address - Phone:813-431-0797
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-02
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW90451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty