Provider Demographics
NPI:1457796088
Name:FEARLESS LOVE, LLC
Entity Type:Organization
Organization Name:FEARLESS LOVE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:MS
Authorized Official - First Name:JIANNY
Authorized Official - Middle Name:D
Authorized Official - Last Name:ADAMO
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, LPC, NCC
Authorized Official - Phone:954-495-4566
Mailing Address - Street 1:238 NE 1ST AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33444-3715
Mailing Address - Country:US
Mailing Address - Phone:954-495-4566
Mailing Address - Fax:954-495-4566
Practice Address - Street 1:238 NE 1ST AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33444-3715
Practice Address - Country:US
Practice Address - Phone:954-495-4566
Practice Address - Fax:954-495-4566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-09
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 11563101Y00000X, 101YM0800X
NJ37PC00463000101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty