Elite Life Counseling
Social Worker, Clinical in Ponte Vedra Beach, FL. Organization (NPI-2).
NPI number1578025490
StatusActive
Last updated in NPPESApr 1, 2019
Details
- NPI
- 1578025490
- Entity type
- Organization (NPI-2)
- Legal business name
- Elite Life Counseling
- Organization subpart
- No
- Enumeration date
- Apr 1, 2019
- Last updated
- Apr 1, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | – | – | Yes |
| 101YM0800X | Counselor, Mental Health | – | – |
Practice location
695 A1a N Unit 113Ponte Vedra Beach, FL 32082-2755
Phone 904-515-5090
Mailing address
3948 3rd St S Ste 507Jacksonville Beach, FL 32250-5847
Authorized official
Brittany Ledford
Therapist
9045155090
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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