Healthcare Provider Details

I. General information

NPI: 1477425098
Provider Name (Legal Business Name): LIVING RESILIENT COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2025
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

907 MAR WALT DR STE 2022
FORT WALTON BEACH FL
32547-6631
US

IV. Provider business mailing address

907 MAR WALT DR STE 2022
FORT WALTON BEACH FL
32547-6631
US

V. Phone/Fax

Practice location:
  • Phone: 850-822-3013
  • Fax: 850-374-3192
Mailing address:
  • Phone: 850-822-3013
  • Fax: 850-374-3192

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. AMBER LYNN GENTRY
Title or Position: MANAGING MEMBER
Credential: LMHC
Phone: 850-496-1280