Healthcare Provider Details

I. General information

NPI: 1235539511
Provider Name (Legal Business Name): KATIE OSTRANDER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2014
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 MOODY BLVD
FLAGLER BEACH FL
32136-3372
US

IV. Provider business mailing address

PO BOX 351056
PALM COAST FL
32135-1056
US

V. Phone/Fax

Practice location:
  • Phone: 386-847-0920
  • Fax:
Mailing address:
  • Phone: 386-847-0920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH15824
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: