Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mangrove Wellness Center, Inc

Organization Mental Health Counselor · NPI 1285987453

Mangrove Wellness Center, Inc provides Mental Health Counselor services in Venice, Florida. Licensed in Florida. Registered with an NPI since 2012.

Licensed in
FL
In the registry since
2012
Specialties on file
4
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1515 Tamiami Trl S Ste 2
Venice, FL 34285 Not confirmed with CMS for 11 years — call before visiting
Phone: (941) 822-5620
Fax: (855) 239-0365
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence MH12785 (FL)
Professional Counselor Taxonomy 101YP2500X · Licence PY5867 (FL)
Professional Counselor Taxonomy 101YP2500X · Licence MH12785 (FL)
Clinical Psychologist Taxonomy 103TC0700X · Licence PY5867 (FL)

Record details

NPI number1285987453
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lisa Reidsema — President · (941) 822-5620
NPI enumeratedOctober 24, 2012
Last updated in NPPESOctober 13, 2014
Mailing address1515 Tamiami Trail S., Suite 2, Venice, FL 34285

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