Healthcare Provider Details

I. General information

NPI: 1235052457
Provider Name (Legal Business Name): FLOURISH FORWARD COUNSELING COLLECTIVE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13A MAIN ST STE 3
SPARTA NJ
07871-1941
US

IV. Provider business mailing address

78 FOREST LAKE DR N
ANDOVER NJ
07821-4014
US

V. Phone/Fax

Practice location:
  • Phone: 862-266-7501
  • Fax:
Mailing address:
  • Phone: 862-266-7501
  • Fax:

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: CAITLYN CAMACHO
Title or Position: CO-OWNER
Credential: LPC, ACS
Phone: 862-266-7501