| Philip J Fauerbach, Lmhc | |
|
915 S Parsons Ave # C Brandon FL 33511-6008 | |
| (813) 651-1221 | |
| (813) 657-0850 |
| Full Name | Philip J Fauerbach, Lmhc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 915 S Parsons Ave # C, Brandon, Florida |
| Authorized Official Name and Position | Philip J Fauerbach (PRESIDENT) |
| Authorized Official Contact | 88136511221 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Philip J Fauerbach, Lmhc 3812 Hanover Hill Dr Valrico FL 33596-7161 Ph: (813) 681-7662 | Philip J Fauerbach, Lmhc 915 S Parsons Ave # C Brandon FL 33511-6008 Ph: (813) 651-1221 |
| NPI Number | 1124491105 |
|---|---|
| Provider Enumeration Date | 11/12/2015 |
| Last Update Date | 11/12/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124491105 | NPI | - | NPPES |
| 761087400 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MH3399 (Florida) | Primary |
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