Provider Demographics
NPI:1851640676
Name:GISONDI, FAITH (MS, LMHC)
Entity Type:Individual
Prefix:
First Name:FAITH
Middle Name:
Last Name:GISONDI
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 SW SAINT LUCIE CRES STE 106
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-2860
Mailing Address - Country:US
Mailing Address - Phone:772-215-2181
Mailing Address - Fax:772-209-7054
Practice Address - Street 1:615 SW SAINT LUCIE CRES STE 106
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2860
Practice Address - Country:US
Practice Address - Phone:772-215-2181
Practice Address - Fax:772-209-7054
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-07
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL13767101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1255888293OtherORGANIZATION NPI