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Organization
J PHYLLIS BRANNEN LCSW CAP
Active
Organization
J PHYLLIS BRANNEN LCSW CAP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
J PHYLLIS BRANNEN LCSW CAP (PRESIDENT)
(321) 953-3225
Entity
Organization
Contact information
Practice address
1503 PINE ST, MELBOURNE, FL 32901-3120
(321) 953-3225
(321) 953-3252
Mailing address
1503 PINE ST, MELBOURNE, FL 32901-3120
(321) 953-3225
(321) 953-3252
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
2553L
FL
1041C0700X
Clinical Social Worker
Primary
SW6239
FL
Other
Enumeration date
09/10/2008
Last updated
09/10/2008
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