Provider Demographics
NPI:1093234494
Name:FORTITUDE COUNSELING, INC
Entity type:Organization
Organization Name:FORTITUDE COUNSELING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:P
Authorized Official - Last Name:HOLLANDSWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:LPCMH
Authorized Official - Phone:302-482-2005
Mailing Address - Street 1:6 DENNY ROAD SUITE 106
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19809
Mailing Address - Country:US
Mailing Address - Phone:302-482-2005
Mailing Address - Fax:302-510-4193
Practice Address - Street 1:6 DENNY RD
Practice Address - Street 2:SUITE 106
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19809
Practice Address - Country:US
Practice Address - Phone:302-482-2005
Practice Address - Fax:302-510-4193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-18
Last Update Date:2017-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC-0000592101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty