Elysian Life Coaching and Counseling Services PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

ELYSIAN LIFE COACHING AND COUNSELING SERVICES PLLC

Practice address

340 W Central Ave Ste 330
Winter Haven, FL 33880-2967

Phone

(863) 266-6024

NPI assigned

Feb 7, 2025

Last updated

Feb 7, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Kenya Coates Charles, LCSW INTERNNPI 1194570507

Title

LCSW Intern

Phone

(863) 266-6024

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kenya Coates Charles

  • Clinical Social Worker
  • Auburndale, FL
  • NPI 1194570507
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1738886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738886400000",
    "number": "1629883665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 W CENTRAL AVE STE 330",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338802967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 W CENTRAL AVE STE 330",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338802967",
            "telephone_number": "863-266-6024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELYSIAN LIFE COACHING AND COUNSELING SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-07",
        "last_updated": "2025-02-07",
        "certification_date": "2025-02-07",
        "status": "A",
        "authorized_official_last_name": "COATES CHARLES",
        "authorized_official_first_name": "KENYA",
        "authorized_official_title_or_position": "LCSW INTERN",
        "authorized_official_telephone_number": "863-266-6024",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW INTERN"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Deanna Elliott, ARNP
• Cynthia L. Elmore, LMHC
• Dana P Elmore, RPH
• Moustafa Elsebey, MD
• Amber Elswick, RMHCI, NCC
• Marsia Emanuel
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• Emergency Care LLC
• Emergent Health Solutions LLC
• Emotional Wellness Therapy LLC

• Clinical Social Worker in Winter Haven, FL
• Providers in Winter Haven, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.