=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356212120
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | UNDER THE UMBRELLA COUNSELING, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/15/2025
-----------------------------------------------------
Last Update Date | 09/15/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 50 LEANNI WAY UNIT B5
-----------------------------------------------------
City | PALM COAST
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32137-4754
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 904-679-1925
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1101 MORGANS TREASURE RD
-----------------------------------------------------
City | SAINT AUGUSTINE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32084-9239
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 904-679-1925
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | LICENSED CLINICAL SOCIAL WORKER
-----------------------------------------------------
Name | ELIZABETH GREENBERGER
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 904-679-1925
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------