Provider Demographics
NPI:1679363865
Name:KIZUNA COUNSELING LLC
Entity type:Organization
Organization Name:KIZUNA COUNSELING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:ALINA
Authorized Official - Middle Name:AYAKO
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:850-496-2029
Mailing Address - Street 1:922 MAR WALT DR STE 200
Mailing Address - Street 2:
Mailing Address - City:FORT WALTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32547-6703
Mailing Address - Country:US
Mailing Address - Phone:850-517-6703
Mailing Address - Fax:850-204-9330
Practice Address - Street 1:922 MAR WALT DR STE 200
Practice Address - Street 2:
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32547-6703
Practice Address - Country:US
Practice Address - Phone:850-517-6703
Practice Address - Fax:850-204-9330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-09
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty