Provider Demographics
NPI:1215661202
Name:TRUEST SELF ENDEAVORS
Entity type:Organization
Organization Name:TRUEST SELF ENDEAVORS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SZYMCZYK
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:407-710-9002
Mailing Address - Street 1:750 STILL RD
Mailing Address - Street 2:
Mailing Address - City:PIERSON
Mailing Address - State:FL
Mailing Address - Zip Code:32180-2696
Mailing Address - Country:US
Mailing Address - Phone:407-710-9002
Mailing Address - Fax:
Practice Address - Street 1:366 E GRAVES AVE STE C
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-5266
Practice Address - Country:US
Practice Address - Phone:407-710-9002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-14
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty