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General NPI Number Information
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NPI Number | 1255764064
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Entity Type | Organization
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Legal Business Name | CENTERPOINTE COUNSELING AND RECOVERY OF BRANDON
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Dates
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Enumeration Date | 08/15/2013
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Last Update Date | 08/15/2013
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Provider Practice Location Address
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Address Line | 403 LITHIA PINECREST RD
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City | BRANDON
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State | FL
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Zip | 33511-6138
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Country | US
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Telephone | 813-262-0471
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Fax | 813-438-8930
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Provider Business Mailing Address
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Address Line | 403 LITHIA PINECREST RD
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City | BRANDON
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State | FL
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Zip | 33511-6138
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Country | US
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Telephone | 813-262-0471
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Fax | 813-438-8930
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Authorized Official
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Title or Position | OWNER
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Name | LYNDON EUGENE COWHERD
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Credential | LMHC, CAP
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Telephone | 813-262-0471
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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 | MH 0002343
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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