Healthcare Provider Details

I. General information

NPI: 1851263370
Provider Name (Legal Business Name): GAVIOTA COUNSELING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2025
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7560 RED BUG LAKE RD
OVIEDO FL
32765-6591
US

IV. Provider business mailing address

7560 RED BUG LAKE RD
OVIEDO FL
32765-6591
US

V. Phone/Fax

Practice location:
  • Phone: 321-505-5405
  • Fax: 407-542-0652
Mailing address:
  • Phone: 321-505-5405
  • Fax: 407-542-0652

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MARLENE SILVA-ROSABAL
Title or Position: DIRECTOR OF OPERATIONS
Credential: LMFT
Phone: 321-505-5405