Healthcare Provider Details

I. General information

NPI: 1598497620
Provider Name (Legal Business Name): PROSPERITY COUNSELING AND COACHING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2022
Last Update Date: 07/20/2022
Certification Date: 07/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 N WYMORE RD
WINTER PARK FL
32789-2822
US

IV. Provider business mailing address

315 N WYMORE RD
WINTER PARK FL
32789-2822
US

V. Phone/Fax

Practice location:
  • Phone: 412-254-6043
  • Fax:
Mailing address:
  • Phone: 412-254-6043
  • Fax:

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 Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name: STEVEN MOLLURA
Title or Position: LPC, LMHC
Credential:
Phone: 412-254-6043