Individual
MR. PHILLIP JAY BROOKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMHC
Contact information
Practice address
1750 17TH ST, BLDG J-2, SARASOTA, FL 34234-8632
(941) 552-2078
(941) 552-2079
Mailing address
705 DEAN AVENUE, SARASOTA, FL 34237
(941) 953-4318
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
MH3098
FL
101YM0800X
Mental Health Counselor
MH3098
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
764872300
—
FL
01
—
MH 3098
LICENSED MH COUNSELOR
FL
Enumeration date
02/16/2006
Last updated
01/11/2011
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