Provider Demographics
NPI:1932648961
Name:MEANINGFULLY CONNECTED LLC
Entity Type:Organization
Organization Name:MEANINGFULLY CONNECTED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:813-373-0315
Mailing Address - Street 1:PO BOX 117
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33509-0117
Mailing Address - Country:US
Mailing Address - Phone:813-373-0315
Mailing Address - Fax:
Practice Address - Street 1:11268 WINTHROP MAIN ST STE 102
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-4266
Practice Address - Country:US
Practice Address - Phone:813-373-0315
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-23
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH11850101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty