Provider Demographics
NPI:1760368625
Name:HUMBLE HYDRATIONS MENTAL WELLNESS & GROWTH, LLC.
Entity type:Organization
Organization Name:HUMBLE HYDRATIONS MENTAL WELLNESS & GROWTH, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:AQUINETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMHC
Authorized Official - Phone:727-712-7692
Mailing Address - Street 1:2850 34TH ST N # 1276
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-3635
Mailing Address - Country:US
Mailing Address - Phone:727-314-5157
Mailing Address - Fax:
Practice Address - Street 1:3110 1ST AVE N SUITE 2M
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-3635
Practice Address - Country:US
Practice Address - Phone:727-314-5157
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty