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:
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Health care specialties

SpecialtyCodeLicense #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 3 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 1740538511 NPPES
Florida MEDICAID 101566900

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