Healthcare Provider Details

I. General information

NPI: 1255764064
Provider Name (Legal Business Name): CENTERPOINTE COUNSELING AND RECOVERY OF BRANDON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2013
Last Update Date: 08/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 LITHIA PINECREST RD
BRANDON FL
33511-6138
US

IV. Provider business mailing address

403 LITHIA PINECREST RD
BRANDON FL
33511-6138
US

V. Phone/Fax

Practice location:
  • Phone: 813-262-0471
  • Fax: 813-438-8930
Mailing address:
  • Phone: 813-262-0471
  • Fax: 813-438-8930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH 0002343
License Number StateFL

VIII. Authorized Official

Name: LYNDON EUGENE COWHERD
Title or Position: OWNER
Credential: LMHC, CAP
Phone: 813-262-0471