Provider Demographics
NPI:1255888293
Name:FAITH GISONDI, LLC
Entity type:Organization
Organization Name:FAITH GISONDI, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FAITH
Authorized Official - Middle Name:
Authorized Official - Last Name:GISONDI
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:772-215-2181
Mailing Address - Street 1:615 SW ST LUCIE CRESCENT
Mailing Address - Street 2:UNIT 106
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:
Practice Address - Street 1:615 SW ST LUCIE CRESCENT
Practice Address - Street 2:UNIT 106
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-07
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM0855X
FLMH13767261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health