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General NPI Number Information
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NPI Number | 1184500381
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Entity Type | Individual
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Provider Name | BRYAN MICHAEL VAN VRANKEN RMHCI
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Gender | Male
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Dates
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Enumeration Date | 08/13/2025
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 2837 1ST AVE N
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City | ST PETERSBURG
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State | FL
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Zip | 33713-8603
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Country | US
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Telephone | 206-485-5209
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Fax |
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Provider Business Mailing Address
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Address Line | 425 17TH AVE NE
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City | ST PETERSBURG
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State | FL
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Zip | 33704-4720
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Country | US
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Telephone | 206-485-5209
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | IMH27867
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License Number State | FL
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