Individual
MR. BRANDON M HOUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMHC
Contact information
Practice address
2200 N PONCE DE LEON BLVD STE 4, ST AUGUSTINE, FL 32084-2650
(208) 716-0425
Mailing address
2200 N PONCE DE LEON BLVD STE 4, ST AUGUSTINE, FL 32084-2650
(208) 716-0425
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LPC3487
ID
101YM0800X
Mental Health Counselor
Primary
MH12288
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010151980
BLUE SHIELD
ID
05
—
002658300
—
ID
01
—
820428306
IDAHO PHYSICIANS NETWORK
ID
01
—
X6882
BLUE CROSS OF IDAHO
ID
Enumeration date
09/14/2006
Last updated
11/24/2015
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