METAMORPHOSIS LIFE REVITALIZING CENTER NPI 1356755060

NPI Information

  • NPI: 1356755060
  • Provider Name: METAMORPHOSIS LIFE REVITALIZING CENTER
  • Classification: Psychologist - 103TC0700X
  • Specialization: Clinical
  • Entity Type: Organization
  • Address: 11700 N 58TH ST
    SUITE J
    TEMPLE TERRACE, FL
    ZIP 33617
  • Phone: (813) 703-2256

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NPI Details

METAMORPHOSIS LIFE REVITALIZING CENTER is a clinical psychologist in Temple Terrace, FL. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. METAMORPHOSIS LIFE REVITALIZING CENTER NPI is 1356755060. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

11700 N 58TH ST
SUITE J
TEMPLE TERRACE, FL
ZIP 33617-666
Phone: (813) 703-2256

The provider's authorized official is April Michelle Jackson-james .
The authorized official title is Managing Partner and has the following contact phone number (813) 703-2256.

The enumeration date for this NPI number is 6/20/2014 and was last updated on 6/20/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103TC0700XPsychologistClinicalPY8197FLORIDAYes

What is NPI?

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This page was last updated on: 11/21/2025

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