| Heroic Counseling Llc | |
|
220 W Brandon Blvd Ste 203 Brandon FL 33511-5100 | |
| (813) 766-3545 | |
| Not Available |
| Full Name | Heroic Counseling Llc |
|---|---|
| Speciality | Counselor |
| Location | 220 W Brandon Blvd Ste 203, Brandon, Florida |
| Authorized Official Name and Position | Marcus Williams (OWNER) |
| Authorized Official Contact | 8137663545 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heroic Counseling Llc 8826 Deep Maple Dr Riverview FL 33578-8981 Ph: (813) 766-3545 | Heroic Counseling Llc 220 W Brandon Blvd Ste 203 Brandon FL 33511-5100 Ph: (813) 766-3545 |
| NPI Number | 1851028013 |
|---|---|
| Provider Enumeration Date | 08/06/2022 |
| Last Update Date | 08/06/2022 |
| Certification Date | 08/06/2022 |
| Medicare PECOS PAC ID | 4486002474 |
|---|---|
| Medicare Enrollment ID | O20231201000840 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851028013 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Marcus D Williams |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1992375927 PECOS PAC ID: 5395193387 Enrollment ID: I20231201000933 |
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