Philip J Fauerbach, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH3399 Issued in FL

Legal business name

PHILIP J FAUERBACH, LMHC

Practice address

915 S Parsons Ave # C
Brandon, FL 33511-6008

Phone

(813) 651-1221

Fax

(813) 657-0850

NPI assigned

Nov 12, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Philip J Fauerbach, LMHCNPI 1912125527

Title

President

Phone

88136511221

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Philip John Fauerbach, LMHC

  • Mental Health Counselor
  • Brandon, FL
  • NPI 1912125527
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1447286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447286400000",
    "number": "1124491105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3812 HANOVER HILL DR",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335967161",
            "telephone_number": "813-681-7662",
            "fax_number": "813-657-0850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 S PARSONS AVE # C",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335116008",
            "telephone_number": "813-651-1221",
            "fax_number": "813-657-0850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILIP J FAUERBACH, LMHC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-12",
        "last_updated": "2015-11-12",
        "status": "A",
        "authorized_official_last_name": "FAUERBACH",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "88136511221",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH3399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "761087400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pharmclinic Two LLC
• Cassandra Phelps, M.S., C.C.C.
• Jenna Phelps, BCABA
• Sharon Phelps
• Tara Ann Philbin, APRN
• Jain Philip
• James Robert Phillips, L.M.H.C.
• John H Phillips, PA-C
• Kimberly Ann Phillips, M.D.
• Phoenix Programs of Florida, Inc.

• Mental Health Counselor in Brandon, FL
• Providers in Brandon, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.