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General NPI Number Information
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NPI Number | 1740739226
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Entity Type | Organization
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Legal Business Name | CONNECTED THRIVING COUNSELING AND WELLNESS
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Dates
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Enumeration Date | 09/26/2016
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 4195 US HIGHWAY 1 STE 102
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City | ROCKLEDGE
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State | FL
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Zip | 32955-5385
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Country | US
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Telephone | 321-720-3444
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Fax |
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Provider Business Mailing Address
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Address Line | 5445 MURRELL RD STE 102-195
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City | ROCKLEDGE
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State | FL
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Zip | 32955-6429
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Country | US
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Telephone | 321-720-3444
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | TIFFANIE MONIQUE TRUDEAU
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Credential |
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Telephone | 321-720-3444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH13469
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License Number State | FL
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