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General NPI Number Information
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NPI Number | 1609687722
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Entity Type | Organization
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Legal Business Name | LIVING FORWARD
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Dates
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Enumeration Date | 01/17/2025
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 450 N PARK RD STE 600
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City | HOLLYWOOD
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State | FL
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Zip | 33021-6918
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Country | US
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Telephone | 954-591-5385
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Fax |
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Provider Business Mailing Address
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Address Line | 3722 WOODFIELD CT
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City | COCONUT CREEK
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State | FL
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Zip | 33073-2226
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Country | US
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Telephone | 954-591-5385
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | TOULA ZOULAS
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Credential |
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Telephone | 954-591-5385
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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