Organization
FAMILY COUNSELING CENTER OF BREVARD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LORI L PARSONS PSY D (PRESIDENT/CEO)
(321) 632-5972
Entity
Organization
Contact information
Practice address
505 BREVARD AVE, SUITE 106, COCOA, FL 32922-7973
(321) 632-5792
(321) 632-5796
Mailing address
505 BREVARD AVE, SUITE 106, COCOA, FL 32922-7973
(321) 632-5792
(321) 632-5796
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
FL
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
060332500
—
FL
05
—
060332502
—
FL
01
—
275892
WELLCARE
FL
01
—
285955
AMERIGROUP
FL
01
—
X0461
BLUE CROSS BLUE SHIELD
FL
01
—
Z067R
BLUE CROSS BLUE SHIELD
FL
Enumeration date
03/28/2006
Last updated
04/25/2016
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