=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861114126
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | INVIGORATE COUNSELING, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/14/2022
-----------------------------------------------------
Last Update Date | 09/14/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 15039 TALL TIMBER BLVD
-----------------------------------------------------
City | HUDSON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34669-1364
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-325-3337
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7957 N UNIVERSITY DR UNIT 1013
-----------------------------------------------------
City | PARKLAND
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33067-2601
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-440-3601
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. LINDSAY HOWARD
-----------------------------------------------------
Credential | PSYD
-----------------------------------------------------
Telephone | 561-440-3601
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0850X
-----------------------------------------------------
Taxonomy Name | Adult Mental Health Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------