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General NPI Number Information
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NPI Number | 1366090730
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Entity Type | Organization
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Legal Business Name | FOUNDATIONS COUNSELING, LLC.
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Dates
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Enumeration Date | 08/29/2019
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Last Update Date | 02/08/2023
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Provider Practice Location Address
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Address Line | 1299 BEDFORD DR STE B2
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City | MELBOURNE
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State | FL
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Zip | 32940-1900
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Country | US
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Telephone | 321-537-6034
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Fax | 321-547-4046
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Provider Business Mailing Address
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Address Line | 1299 BEDFORD DR STE B2
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City | MELBOURNE
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State | FL
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Zip | 32940-1900
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Country | US
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Telephone | 321-622-8104
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Fax | 321-547-4046
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR/OWNER
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Name | MS. RAYNA BRAVO
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Credential |
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Telephone | 321-622-8104
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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