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Organization

OLIVE COUNSELING LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JACOB SANTHOUSE EDD, LCPC (CEO)
(312) 883-4077
Entity
Organization

Contact information

Practice address
1700 66TH ST N # 104-312, ST PETERSBURG, FL 33710-5544
(312) 883-4077
Mailing address
9978 57TH AVE N, ST PETERSBURG, FL 33708-3428
(312) 883-4077

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary

Other

Enumeration date
11/23/2020
Last updated
04/25/2025
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