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Organization
PHILIP J FAUERBACH, LMHC
Active
Organization
PHILIP J FAUERBACH, LMHC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILIP J FAUERBACH LMHC (PRESIDENT)
88136511221
Entity
Organization
Contact information
Practice address
915 S PARSONS AVE # C, BRANDON, FL 33511-6008
(813) 651-1221
(813) 657-0850
Mailing address
3812 HANOVER HILL DR, VALRICO, FL 33596-7161
(813) 681-7662
(813) 657-0850
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH3399
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
761087400
—
FL
Enumeration date
11/12/2015
Last updated
11/12/2015
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