Organization
BREVARD COUNSELING ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY A SUMMERFIELD LMHC (OWNER)
(321) 328-8664
Entity
Organization
Contact information
Practice address
1589 S WICKHAM RD, MELBOURNE, FL 32904-3540
(321) 328-8664
(321) 325-1949
Mailing address
1589 S WICKHAM RD, MELBOURNE, FL 32904-3540
(321) 328-8664
(321) 325-1949
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
MH13868
FL
101YA0400X
Addiction (Substance Use Disorder) Counselor
MH13868
FL
101YM0800X
Mental Health Counselor
Primary
MH13868
FL
101YP2500X
Professional Counselor
MH13868
FL
Other
Enumeration date
01/09/2016
Last updated
01/09/2016
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