Provider Demographics
NPI:1609115427
Name:PROACTIVE SOLUTIONS THERAPY, LLC
Entity Type:Organization
Organization Name:PROACTIVE SOLUTIONS THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ANTHIA
Authorized Official - Middle Name:ELIZA
Authorized Official - Last Name:CASANOVA
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC/CAP
Authorized Official - Phone:813-802-2025
Mailing Address - Street 1:8304 RIVERBOAT DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33637-6580
Mailing Address - Country:US
Mailing Address - Phone:813-802-2025
Mailing Address - Fax:
Practice Address - Street 1:2203 N LOIS AVE
Practice Address - Street 2:STE 961
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-2370
Practice Address - Country:US
Practice Address - Phone:813-802-2025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-14
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCAP 4805101YA0400X
FLMH 11051101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty