Organization

Family Counseling Center Of Brevard, Inc.

Community/Behavioral Health Agency in Rockledge, FL(View on Map)

Legal Business Name

Family Counseling Center Of Brevard, Inc.

NPI Number

1912053919

NPI Type

Organization

Enumeration Date

01/25/2007

Specialties

(Taxonomies)

Code

251S00000X

Primary Taxonomy

Yes

Licenses

State

Florida

License Number

SW5110

Contact
Information

Purpose

Mailing
Location

Address

840 BREVARD AVE
840 BREVARD AVE

City

Rockledge
Rockledge

State

FL
FL

Postal Code

32955-2149
32955-2149

Country

US
US

Telephone Number

(321) 632-5792
(321) 632-5792

Authorized Official

Name

Mr. Phillip Kolodziej

Title or Position

PRESIDENT

Telephone Number

(321) 632-5792

Identifiers

Identifier

060332500
275862
62-40039

Identifier State

FL
FL
FL

Identifier Issuer

Unknown
CLINICAL SOCIAL WORKER
CLINICAL SOCIAL WORKER

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 04/22/2008

Provider Address

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