FAMILY COUNSELING CENTER OF BREVARD, INC. (NPI# 1912053919) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912053919 |
| Entity Type | Organization |
| Organization Name | FAMILY COUNSELING CENTER OF BREVARD, INC. |
| Practice Address |
840 Brevard Ave Rockledge FL 32955-2149 |
| Practice Telephone | 3216325792 |
| Practice Fax Number | 3216325796 |
| Mailing Telephone | 3216325792 |
| Mailing Fax Number | 3216325796 |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2008-04-22 |
| Authorized Official Name | MR. PHILLIP KOLODZIEJ (PRESIDENT) |
| Authorized Official Telephone | 3216325792 |
| Authorized Official Credential | MSW, ACSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | SW5110 | FL | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | CLINICAL SOCIAL WORKER | 275862 | 01 |
| FL | CLINICAL SOCIAL WORKER | 62-40039 | 01 |
| FL | 060332500 | 05 |
| Street Address |
840 BREVARD AVE |
| City | ROCKLEDGE |
| State | FL |
| Zip Code | 32955-2149 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356689616 | Karen A Delos Santos | Counselor | 840 Brevard Ave, Rockledge, FL 32955-2149 | 2013-01-22 |
| 1871899294 | Gineva Bussen | Social Worker | 840 Brevard Ave, Rockledge, FL 32955-2149 | 2011-02-02 |
| 1700026341 | Kimberly A Kanarick | Counselor | 840 Brevard Ave, Rockledge, FL 32955-2149 | 2009-02-23 |
| 1437398658 | Elizabeth Marian Wilder | Counselor | 840 Brevard Ave, Rockledge, FL 32955-2149 | 2009-02-11 |
| 1811136047 | Robert L Cravens | Counselor | 840 Brevard Ave, Rockledge, FL 32955-2149 | 2009-02-11 |
| 1508990896 | Daniel Louis Bologna | Social Worker | 840 Brevard Ave, Rockledge, FL 32955-2149 | 2007-03-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477169571 | Health First Medical Group LLC | Orthopaedic Surgery | 6525 3rd Street, #302, Rockledge, FL 32955 | 2020-09-23 |
| 1063037810 | Endo Now LLC | Internal Medicine | 5460 Village Drive,viera, Rockledge, FL 32955 | 2020-06-08 |
| 1588285100 | Enrique Technologies & Trading, LLC | Meals | 1841 Long Iron Dr. Ste. 805, Rockledge, FL 32955 | 2020-05-05 |
| 1578101549 | Ericka Marshall | Counselor | 7095 Turner Road, Rockledge, FL 32955 | 2019-12-20 |
| 1174168322 | Brevard Pharmacy L.L.C. | Pharmacy | 401. Barton Blvd., Rockledge, FL 32955 | 2019-11-12 |
| 1770131443 | Fyzical Therapy & Balance Center Rockledge-viera | Clinic/Center | 634 Barnes Boulevard, Unit 202, Rockledge, FL 32955 | 2019-08-27 |
| 1699261461 | Brookview Manor Assisted Living Facility LLC | Assisted Living Facility | 882 Brookview Ln, Rockledge, FL 32955 | 2018-07-05 |
| 1750888970 | Kaitlin Donovan | Dentist | 5380 Stadium Pkwy Ste 119, Rockledge, FL 32955 | 2018-04-13 |
| 1376041327 | Serina Eder | Acupuncturist | 5595 Schenck Ave Ste 7, Rockledge, FL 32955 | 2018-01-24 |
| 1427563394 | Suntree Orthopedics, LLC | Orthopaedic Surgery | 6525 3rd St Ste 302-303, Rockledge, FL 32955 | 2017-12-13 |
| Find all providers in zip 32955 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548728991 | Right Mind Counseling and Consultation | Community/Behavioral Health | 992 Demaret Dr, Rockledge, FL 32955-2333 | 2019-03-05 |
| 1215237342 | Brevard Achievement Center | Community/Behavioral Health | 1845 Cogswell Street, Rockledge, FL 32955 | 2010-10-22 |
| 1427284371 | Links of Hope | Community/Behavioral Health | 1535 Cogswell St, Suite C-20, Rockledge, FL 32955-2738 | 2009-06-05 |
| 1174950950 | Brevard Achievement Center | Community/Behavioral Health | 1845 Cogswell St, Rockledge, FL 32955-3210 | 2013-10-11 |
| 1104157049 | Center for Counseling and Hypnosis, Inc. | Community/Behavioral Health | 1027 Pathfinder Way, Suite 112, Rockledge, FL 32955-3267 | 2010-01-15 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.