Provider Demographics
NPI:1922727320
Name:COUNSELING RESOURCE CENTER OF TAMPA BAY, INC.
Entity Type:Organization
Organization Name:COUNSELING RESOURCE CENTER OF TAMPA BAY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:W
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:III
Authorized Official - Credentials:LMHC
Authorized Official - Phone:727-432-0748
Mailing Address - Street 1:7208 MASSACHUSETTS AVE
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34653-2934
Mailing Address - Country:US
Mailing Address - Phone:727-432-0748
Mailing Address - Fax:727-339-3310
Practice Address - Street 1:7208 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653-2934
Practice Address - Country:US
Practice Address - Phone:727-432-0748
Practice Address - Fax:727-339-3310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-26
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty