Jeremy, Brent Alan

Jeremy, Brent Alan is an sole proprietor health care provider with primary practice located at 2525 20Th St. , Vero Beach FL 32960-3026. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Jeremy, Brent Alan can be contacted via phone (772) 567-6508.

Contact Information

Primary practice address
2525 20Th St. Vero Beach FL 32960-3026
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X SW 4445 Florida

Profile Details

NPI number 1811100845
LBN Legal business name Jeremy, Brent Alan
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 7th, 2007
Last updated Feb 10th, 2008 - about 16 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 1811100845 NPPES
Florida Other AH367Z PTAN

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