Provider Demographics
NPI:1740706647
Name:REASONOVER COUNSELING AND CONSULTING
Entity type:Organization
Organization Name:REASONOVER COUNSELING AND CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:TAYLOR
Authorized Official - Last Name:REASONOVER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:904-993-0019
Mailing Address - Street 1:305 KINGSLEY LAKE DR STE 702
Mailing Address - Street 2:
Mailing Address - City:SAINT AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32092-3045
Mailing Address - Country:US
Mailing Address - Phone:904-993-0019
Mailing Address - Fax:904-993-0020
Practice Address - Street 1:305 KINGSLEY LAKE DR STE 702
Practice Address - Street 2:
Practice Address - City:SAINT AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32092-3045
Practice Address - Country:US
Practice Address - Phone:904-993-0019
Practice Address - Fax:904-993-0020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW146401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty