Provider Demographics
NPI:1669096400
Name:NAGLE, BJORN (RMHCI)
Entity type:Individual
Prefix:MR
First Name:BJORN
Middle Name:
Last Name:NAGLE
Suffix:
Gender:M
Credentials:RMHCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 CENTRAL AVE UNIT 714
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-3672
Mailing Address - Country:US
Mailing Address - Phone:941-301-1621
Mailing Address - Fax:
Practice Address - Street 1:111 2ND AVE NE STE 1007
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-3442
Practice Address - Country:US
Practice Address - Phone:727-344-9867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-06
Last Update Date:2020-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL18983101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health