Organization
BEVERLY WILUSZ
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BEVERLY WILUSZ LMHC (OWNER)
(850) 301-0446
Entity
Organization
Contact information
Practice address
228 BROOKS ST SE STE A, FORT WALTON BEACH, FL 32548-2821
(850) 301-0446
(850) 301-0442
Mailing address
PO BOX 846, FORT WALTON BEACH, FL 32549-0846
(850) 301-0446
(850) 301-0442
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MH-2007
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MH-2007
FLORIDA BLUE
FL
Enumeration date
06/04/2014
Last updated
06/04/2014
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