Provider Demographics
NPI:1386385755
Name:EVERTHRIVE COUNSELING LLC
Entity type:Organization
Organization Name:EVERTHRIVE COUNSELING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DE GRAAF
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:833-473-3399
Mailing Address - Street 1:6014 US HIGHWAY 19 STE 303
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34652-2547
Mailing Address - Country:US
Mailing Address - Phone:833-473-3399
Mailing Address - Fax:
Practice Address - Street 1:6014 US HIGHWAY 19 STE 303
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-2547
Practice Address - Country:US
Practice Address - Phone:833-473-3399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-07
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1932553815OtherINDIVIDUAL NPI