NORTHSIDE BEHAVIORAL HEALTH CENTER, INC.
NPI 1659672715
General Practice in Tampa, FL

Q: What is Northside Behavioral Health Center, Inc.'s specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Active since November 05, 2010CLIA 10D0995793 · Waiver

12512 BRUCE B DOWNS BLVD, TAMPA, FL 33612(813) 977-8700(813) 971-2029 Get Directions Write a Review

NPPES record last updated: December 7, 2021. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Dec 7, 2021, Jul 15, 2021 (2 updates tracked since 2021).

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About Northside Behavioral Health Center, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NORTHSIDE BEHAVIORAL HEALTH CENTER, INC. (NPI 1659672715) is a healthcare organization registered as a general practice in Tampa, Florida and active in the NPI registry since November 2010. The organization holds a CLIA Waiver certificate valid through January 30, 2028 and lists Kristina M Hust, Director Of Operations, as its authorized official.

NPPES Registry Identity

NPI1659672715

Entity TypeOrganization

Primary Taxonomy208D00000X

Legal Business NameNORTHSIDE BEHAVIORAL HEALTH CENTER, INC.

Location Address12512 BRUCE B DOWNS BLVDTampa, FL 33612-9209

Mailing Address12512 Bruce B Downs BlvdTampa, FL 33612-9209 · (813) 977-8700 · Fax (813) 971-2029

Phone(813) 977-8700

Fax(813) 971-2029

Organization SubpartNo

Authorized OfficialKristina M HustDirector Of Operations · (813) 977-8700

Enumeration DateNovember 5, 2010

Last NPPES UpdateDecember 7, 20212 updates tracked since enumeration

NPPES CertifiedDecember 7, 2021

✔ NPI 1659672715 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

Also ListedClinic/CenterTaxonomy 261Q00000X · License 8522 (FL)

12512 BRUCE B DOWNS BLVD, Tampa, FL 33612

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Other Identifiers 2

Medicaid060370800FL

Medicaid060370807FL

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D0995793

Northside Behavioral Health Center Inc · Tampa, FL

Active · expires Jan 30, 2028

CLIA Number10D0995793

Laboratory TypeCommunity Mental Health

Certificate Effective DateJanuary 31, 2026

Certificate Expiration DateJanuary 30, 2028

Laboratory DirectorDaniel Croft

Laboratory Phone(813) 977-8700

Laboratory LocationNorthside Behavioral Health Center Inc12512 Bruce B Downs Blvd, Tampa, FL 33612

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. GARY A. VITACCO-ROBLES LMHC, NCC

Counselor (Mental Health)