Provider Demographics
NPI:1164842761
Name:GROUNDWORK COUNSELING LLC
Entity Type:Organization
Organization Name:GROUNDWORK COUNSELING LLC
Other - Org Name:GROUNDWORK COGNITIVE BEHAVIORAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUE
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, NCC
Authorized Official - Phone:407-378-3000
Mailing Address - Street 1:341 N MAITLAND AVE STE 330
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-4761
Mailing Address - Country:US
Mailing Address - Phone:407-378-3000
Mailing Address - Fax:407-378-3004
Practice Address - Street 1:341 N MAITLAND AVE STE 330
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4761
Practice Address - Country:US
Practice Address - Phone:407-378-3000
Practice Address - Fax:407-378-3004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-22
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)