Willis, Brian E
Willis, Brian E is an sole proprietor health care provider with primary practice located at 5642 Jones St , Milton FL 32570-2304. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Willis, Brian E can be contacted via phone (850) 626-7779.Contact Information
Primary practice address
5642 Jones St
Milton FL 32570-2304
Phone: (850) 626-7779
Fax: (850) 626-7171
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | MH 11927 | Florida |
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | MH11927 | Florida |
Profile Details
| NPI number | 1740538511 |
|---|---|
| LBN Legal business name | Willis, Brian E |
| Credentials | LMHC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 27th, 2012 |
| Last updated | Aug 12th, 2022 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1740538511 | NPPES |
| Florida | MEDICAID | 101566900 |
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