| Therapy Center Of Brevard, Llc | |
|
380 Newport Dr Indialantic FL 32903-4021 | |
| (321) 722-9986 | |
| Not Available |
| Full Name | Therapy Center Of Brevard, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 380 Newport Dr, Indialantic, Florida |
| Authorized Official Name and Position | Haya Soya (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 3213287692 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Therapy Center Of Brevard, Llc 870 N Miramar Ave # 345 Indialantic FL 32903-3054 Ph: (321) 722-9986 | Therapy Center Of Brevard, Llc 380 Newport Dr Indialantic FL 32903-4021 Ph: (321) 722-9986 |
| NPI Number | 1659658698 |
|---|---|
| Provider Enumeration Date | 11/04/2011 |
| Last Update Date | 08/03/2021 |
| Certification Date | 08/03/2021 |
| Medicare PECOS PAC ID | 2163697822 |
|---|---|
| Medicare Enrollment ID | O20111207000411 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659658698 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY8406 (Florida) | Primary |
| Provider Name | Haya Soya |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437433828 PECOS PAC ID: 5799950226 Enrollment ID: I20111214000397 |
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