TINY REBELLION LLC NPI 1619893377

NPI Information

  • NPI: 1619893377
  • Provider Name: TINY REBELLION LLC
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Organization
  • Address: 7205 64TH WAY N
    PINELLAS PARK, FL
    ZIP 33781
  • Phone: (970) 784-0255

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NPI Details

TINY REBELLION LLC is a mental health counselor in Pinellas Park, FL. TINY REBELLION LLC NPI is 1619893377. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

7205 64TH WAY N
PINELLAS PARK, FL
ZIP 33781-027
Phone: (970) 784-0255

The provider's authorized official is Mike Johnson .
The authorized official title is Manager and has the following contact phone number (970) 784-0255.

The enumeration date for this NPI number is 6/26/2026 and was last updated on 6/26/2026.

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
1101YM0800XCounselorMental HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

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

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