Healthcare Provider Details

I. General information

NPI: 1104655463
Provider Name (Legal Business Name): STRIVE COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2024
Last Update Date: 07/26/2024
Certification Date: 07/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1750 A1A S STE A
ST AUGUSTINE FL
32080-5582
US

IV. Provider business mailing address

1750 A1A S STE A
ST AUGUSTINE FL
32080-5582
US

V. Phone/Fax

Practice location:
  • Phone: 904-990-4524
  • Fax: 904-770-3818
Mailing address:
  • Phone: 904-990-4524
  • Fax: 904-770-3818

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 Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. LINDSAY FABER
Title or Position: OWNER/LICENSED THERAPIST
Credential: LMHC, LMFT, QS
Phone: 904-990-4524