Fauerbach, Philip John

Fauerbach, Philip John is an individual health care provider with primary practice located at 915 S Parsons Ave # C, Brandon FL 33511-6008. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Fauerbach, Philip John can be contacted via phone (813) 651-1221.

Contact Information

Primary practice address
915 S Parsons Ave # C Brandon FL 33511-6008
Fax: (813) 657-0850
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X MH3399 Florida

Profile Details

NPI number 1912125527
LBN Legal business name Fauerbach, Philip John
Credentials LMHC
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 22nd, 2007
Last updated Nov 11th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912125527 NPPES
Florida MEDICAID 761087400

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