Healthcare Provider Details

I. General information

NPI: 1184935314
Provider Name (Legal Business Name): BRADLEY JEAN VAN HOEK MBA,MA,MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2010
Last Update Date: 09/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 WORTH AVE SUITE 201
PALM BEACH FL
33480-4606
US

IV. Provider business mailing address

205 WORTH AVE SUITE 201
PALM BEACH FL
33480-4606
US

V. Phone/Fax

Practice location:
  • Phone: 561-281-1693
  • Fax:
Mailing address:
  • Phone: 561-281-1693
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberAPA 12141
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH10473
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberMH10473
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License NumberMH10473
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: