MEDICARE: MS. BRADLEY JEAN VAN HOEK MBA,MA,MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	APA 12141	FL
2	101YM0800X	Mental Health Counselor	MH10473	FL
3	101YA0400X	Addiction (Substance Use Disorder) Counselor	MH10473	FL
4	101YP1600X	Pastoral Counselor	MH10473	FL

General Provider Information

NPI Number	:	1184935314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BRADLEY JEAN VAN HOEK MBA,MA,MS

Provider Business Mailing Address
First Line	:	205 WORTH AVE
Second Line	:	SUITE 201
City	:	PALM BEACH
State	:	FL
Zip	:	33480-4606
Country	:	US
Telephone Number	:	561-281-1693
Fax Number	:

Provider Business Practice Location Address
First Line	:	205 WORTH AVE
Second Line	:	SUITE 201
City	:	PALM BEACH
State	:	FL
Zip	:	33480-4606
Country	:	US
Telephone Number	:	561-281-1693
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2010
Last Update Date	:	09/12/2011

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