Healthcare Provider Details

I. General information

NPI: 1366016552
Provider Name (Legal Business Name): HEALTHFUL GUIDANCE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2021
Last Update Date: 06/22/2021
Certification Date: 06/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 E SILVER SPRINGS BLVD STE 11
OCALA FL
34470-6711
US

IV. Provider business mailing address

PO BOX 770481
OCALA FL
34477-0481
US

V. Phone/Fax

Practice location:
  • Phone: 352-286-3118
  • Fax: 352-290-4160
Mailing address:
  • Phone: 352-286-3118
  • Fax: 352-290-4160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. LASHAUNIA DANIELLE BROOKS
Title or Position: CLINICAL SOCIAL WORKER/THERAPIST
Credential: LCSW
Phone: 352-286-3118