Organization
FAMILY COUNSELING CENTER OF BREVARD, INC.
Active
Organization
FAMILY COUNSELING CENTER OF BREVARD, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILLIP KOLODZIEJ MSW, ACSW (PRESIDENT)
(321) 632-5792
Entity
Organization
Contact information
Practice address
840 BREVARD AVE, ROCKLEDGE, FL 32955-2149
(321) 632-5792
(321) 632-5796
Mailing address
840 BREVARD AVE, ROCKLEDGE, FL 32955-2149
(321) 632-5792
(321) 632-5796
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
SW5110
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
060332500
—
FL
01
—
275862
CLINICAL SOCIAL WORKER
FL
01
—
62-40039
CLINICAL SOCIAL WORKER
FL
Enumeration date
01/25/2007
Last updated
04/22/2008
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