| Family Counseling Center Of Brevard, Inc. | |
|
840 Brevard Ave Rockledge FL 32955-2149 | |
| (321) 632-5792 | |
| (321) 632-5796 |
| Full Name | Family Counseling Center Of Brevard, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 840 Brevard Ave, Rockledge, Florida |
| Authorized Official Name and Position | Phillip Kolodziej (PRESIDENT) |
| Authorized Official Contact | 3216325792 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Counseling Center Of Brevard, Inc. 840 Brevard Ave Rockledge FL 32955-2149 Ph: (321) 632-5792 | Family Counseling Center Of Brevard, Inc. 840 Brevard Ave Rockledge FL 32955-2149 Ph: (321) 632-5792 |
| NPI Number | 1912053919 |
|---|---|
| Provider Enumeration Date | 01/25/2007 |
| Last Update Date | 04/22/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912053919 | NPI | - | NPPES |
| 060332500 | Medicaid | FL | |
| 275862 | Other | FL | CLINICAL SOCIAL WORKER |
| 62-40039 | Other | FL | CLINICAL SOCIAL WORKER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | SW5110 (Florida) | Primary |
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