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Individual

MR. WILSON BEZERRA FLANDERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MA, LPCC, LMHC

Contact information

Practice address
751 EBLITHEDALE AVE., # 643, MILL VALLEY, CA 94942-0643
(415) 647-9839
(415) 390-1245
Mailing address
751 EBLITHEDALE AVE. # 643, MILL VALLEY, CA 94942-0643
(415) 647-9839
(415) 390-1245

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
3092
NY
101YM0800X
Mental Health Counselor
6018
MA
101YM0800X
Mental Health Counselor
MH 8586
FL
101YP2500X
Professional Counselor
Primary
3902
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
267048
COMPSYNCH
FL
01
2677850
CIGNA
FL
01
2798432
UNITED BEHAVIORAL
FL
01
311546
LIFESYNCH/CORP HEALTH
FL
01
593439351
HUMANA MILITARY
FL
01
9589228
AETNA
FL
01
Z102-X
BCBSFL
FL
Enumeration date
02/12/2007
Last updated
12/01/2021
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