MEDICARE: TRAUMA SOLUTIONS COUNSELING, 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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1881422269
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRAUMA SOLUTIONS COUNSELING, LLC

Provider Business Mailing Address
First Line	:	3576 MOONSTONE DR
Second Line	:
City	:	NAVARRE
State	:	FL
Zip	:	32566-9824
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	348 MIRACLE STRIP PKWY SW STE 24
Second Line	:
City	:	FORT WALTON BEACH
State	:	FL
Zip	:	32548-5263
Country	:	US
Telephone Number	:	850-498-6858
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	STACY RUSH
Credential	:	LPC
Telephone Number	:	808-726-6404

Provider Enumeration Date	:	07/25/2024
Last Update Date	:	07/25/2025

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