BLUE LEAF THERAPY NPI 1790563740

NPI Information

  • NPI: 1790563740
  • Provider Name: BLUE LEAF THERAPY
  • Classification: Clinic/Center - 261QM0801X
  • Specialization: Mental Health (Including Community Mental Health Center)
  • Entity Type: Organization
  • Address: 1828 S FLORIDA AVE
    LAKELAND, FL
    ZIP 33803
  • Phone: (863) 272-9633

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NPI Details

BLUE LEAF THERAPY is a mental health (including community mental health center) clinic center in Lakeland, FL. BLUE LEAF THERAPY NPI is 1790563740. The provider is registered as an organization entity type.

The provider's business location address is:

1828 S FLORIDA AVE
LAKELAND, FL
ZIP 33803-654
Phone: (863) 272-9633

The provider's authorized official is Ellie N Choate .
The authorized official title is Therapist and has the following contact phone number (717) 609-3626.

The enumeration date for this NPI number is 9/20/2023 and was last updated on 1/5/2024.

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
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)Yes

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: 3/30/2025

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