Brilliant Minds
Organization Active NPI Counselor · Destin, FL
NPI 1720101736 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1720101736
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Counselor 101Y00000X
- License
- 90051001284 (FL)
- Legal business name
- BRILLIANT MINDS
- Practice address
- 36468 Emerald Coast Pkwy
Suite 2101
Destin, FL 32541-4799 - Phone
- (850) 837-1200
- Fax
- (850) 269-2341
- NPI assigned
- Apr 6, 2007
- Organization subpart
- No
Authorized official
- Name
- Miss Gina M Ballone
- Title
- Clincal Director
- Phone
- (850) 837-1200
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor |
101Y00000X | 90051001284 | FL | Yes |
Addresses
Primary practice location
36468 Emerald Coast Pkwy
Suite 2101
Destin, FL 32541-4799
Mailing address
36468 Emerald Coast Pkwy
Suite 2101
Destin, FL 32541
Phone (850) 837-1200
Other providers in Destin, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.