MEDICARE: SOULUTION-FOCUSED THERAPY & COACHING, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1578313565
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOULUTION-FOCUSED THERAPY & COACHING, LLC

Provider Business Mailing Address
First Line	:	827 LAUREL AVE
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32803-4043
Country	:	US
Telephone Number	:	321-317-8726
Fax Number	:

Provider Business Practice Location Address
First Line	:	827 LAUREL AVE
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32803-4043
Country	:	US
Telephone Number	:	321-317-8726
Fax Number	:

Authorized Official
Title or Position	:	LICENSED CLINICAL SOCIAL WORKER
Name	:	MRS. GISELLE LABOY
Credential	:	LCSW
Telephone Number	:	213-178-7263

Provider Enumeration Date	:	03/25/2024
Last Update Date	:	03/25/2024

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