Provider Demographics
NPI:1972333433
Name:HOLISTIC PSYCHIATRY, LLC
Entity type:Organization
Organization Name:HOLISTIC PSYCHIATRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:LEAH
Authorized Official - Last Name:TRAUTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:352-238-7234
Mailing Address - Street 1:14308 LELANI DR
Mailing Address - Street 2:
Mailing Address - City:WEEKI WACHEE
Mailing Address - State:FL
Mailing Address - Zip Code:34614-1924
Mailing Address - Country:US
Mailing Address - Phone:352-238-7234
Mailing Address - Fax:
Practice Address - Street 1:3502 HENDERSON BLVD STE 312
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-4087
Practice Address - Country:US
Practice Address - Phone:352-763-3936
Practice Address - Fax:352-204-1580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty