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Organization
SPIRES BEHAVIORAL HEALTH CARE CENTER, PLLC
Active
Organization
SPIRES BEHAVIORAL HEALTH CARE CENTER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIE EARL SPIRES PH.D., L.M.H.C. (EXECUTIVE DIRECTOR)
(850) 482-4177
Entity
Organization
Contact information
Practice address
4428 LAFAYETTE STREET, MARIANNA, FL 32447-5728
(850) 482-4177
(850) 482-4178
Mailing address
PO BOX 5728, 4428 LAFAYETTE STREET, MARIANNA, FL 32447-5728
(850) 482-4177
(850) 482-4178
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH0026
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000258100
—
FL
01
—
600562012
MAGELLAN BEHAVIORAL HEALTH
FL
Enumeration date
07/31/2014
Last updated
07/31/2014
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