Healthcare Provider Details

I. General information

NPI: 1962049387
Provider Name (Legal Business Name): CATALYST COUNSELING ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2019
Last Update Date: 06/01/2020
Certification Date: 06/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 LOUISIANA AVE STE A
SAINT CLOUD FL
34769-4116
US

IV. Provider business mailing address

4724 LAKE TRUDY DR
SAINT CLOUD FL
34769-1668
US

V. Phone/Fax

Practice location:
  • Phone: 407-593-0122
  • Fax:
Mailing address:
  • Phone: 407-205-2597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CELESTE TITUS
Title or Position: OWNER/OPERATOR
Credential: LMHC
Phone: 407-593-0122