MEDICARE: GIRLANDO COUNSELING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1558103952
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GIRLANDO COUNSELING LLC

Provider Business Mailing Address
First Line	:	2533 SE DOGWOOD AVE
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34952-6515
Country	:	US
Telephone Number	:	772-209-2881
Fax Number	:

Provider Business Practice Location Address
First Line	:	2533 SE DOGWOOD AVE
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34952-6515
Country	:	US
Telephone Number	:	772-209-2881
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOTHERAPIST/OWNER
Name	:	LAURA ANNE GIRLANDO
Credential	:	LMHC
Telephone Number	:	772-209-2881

Provider Enumeration Date	:	06/07/2024
Last Update Date	:	06/13/2024

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