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Organization

BRAINCLICK COUNSELING

Active
Other names
BrainClick Online Counseling
Organization subpart
No

Provider details

NPI number
Authorized official
MR. PHILLIP EDWARD VAN KLEECK M.A. (OWNER / ADMINISTRATOR)
(863) 214-2046
Entity
Organization

Contact information

Practice address
135 LARGS CT, #308, DUNEDIN, FL 34698-8386
(863) 214-2046
Mailing address
135 LARGS CT, #308, DUNEDIN, FL 34698-8386
(863) 214-2046

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH9545
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1093990016
FL
Enumeration date
09/26/2016
Last updated
09/26/2016
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