Provider Demographics
NPI:1790926178
Name:OUR UPWARD SPIRAL, LLC
Entity Type:Organization
Organization Name:OUR UPWARD SPIRAL, LLC
Other - Org Name:UPWARD SPIRAL COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GUARIONEX
Authorized Official - Middle Name:E
Authorized Official - Last Name:DEL ORBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-453-5402
Mailing Address - Street 1:5470 E BUSCH BLVD
Mailing Address - Street 2:NUMBER 424
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33617-5418
Mailing Address - Country:US
Mailing Address - Phone:813-374-2139
Mailing Address - Fax:813-374-2138
Practice Address - Street 1:10320 N 56TH ST
Practice Address - Street 2:SUITE 340
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33617-4071
Practice Address - Country:US
Practice Address - Phone:813-374-2139
Practice Address - Fax:813-453-5402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-16
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH6176101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty