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General NPI Number Information
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NPI Number | 1093442576
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Entity Type | Organization
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Legal Business Name | HIS DESIGN COUNSELING
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Dates
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Enumeration Date | 08/04/2022
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Last Update Date | 08/04/2022
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Provider Practice Location Address
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Address Line | 3301 14TH ST W
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City | BRADENTON
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State | FL
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Zip | 34205-6208
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Country | US
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Telephone | 941-773-1435
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Fax |
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Provider Business Mailing Address
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Address Line | 6259 WINGSPAN WAY
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City | BRADENTON
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State | FL
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Zip | 34203-7121
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Country | US
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Telephone | 941-773-1435
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DARCY M BROWN
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Credential | LCSW
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Telephone | 941-773-1435
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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