Organization
EDIFY COUNSELING GROUP LLC
Active
Other names
Edify Creative Counseling Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON-ANTHONY KIRKHAM PRENDERGAST PHD, MBA, BS. (PRESIDENT & CEO)
(888) 773-3439
Entity
Organization
Contact information
Practice address
1451 W CYPRESS CREEK RD, FORT LAUDERDALE, FL 33309-1961
(888) 773-3439
Mailing address
1451 W CYPRESS CREEK RD STE 300, FORT LAUDERDALE, FL 33309-1953
(888) 773-3439
(888) 773-3439
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP1600X
Pastoral Counselor
—
—
101YP2500X
Professional Counselor
Primary
17769
FL
261Q00000X
Clinic/Center
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Enumeration date
02/07/2018
Last updated
09/29/2025
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