Healthcare Provider Details

I. General information

NPI: 1598308033
Provider Name (Legal Business Name): GRATITUDE COUNSELING GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2019
Last Update Date: 08/18/2023
Certification Date: 08/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 E TOWN PL STE 110C
SAINT AUGUSTINE FL
32092-2726
US

IV. Provider business mailing address

101 E TOWN PL STE 110C
SAINT AUGUSTINE FL
32092-2726
US

V. Phone/Fax

Practice location:
  • Phone: 239-800-9136
  • Fax:
Mailing address:
  • Phone: 239-800-9136
  • Fax: 239-266-2001

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. EMILY KAREN NARANJO
Title or Position: LCSW
Credential: LCSW
Phone: 239-293-4411