Provider Demographics
NPI:1801320478
Name:PINNACLE ADHD COUNSELING LLC
Entity type:Organization
Organization Name:PINNACLE ADHD COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIXON-TALIAFERRO
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:941-465-0686
Mailing Address - Street 1:8884 FOUNCERS CIR
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34221
Mailing Address - Country:US
Mailing Address - Phone:941-465-0686
Mailing Address - Fax:727-623-4283
Practice Address - Street 1:200 CENTRAL AVE
Practice Address - Street 2:SUITE 18-G
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4353
Practice Address - Country:US
Practice Address - Phone:941-465-0686
Practice Address - Fax:727-623-4283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-20
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH13626251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017309800Medicaid