Provider Demographics
NPI:1255764064
Name:CENTERPOINTE COUNSELING AND RECOVERY OF BRANDON
Entity type:Organization
Organization Name:CENTERPOINTE COUNSELING AND RECOVERY OF BRANDON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LYNDON
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:COWHERD
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, CAP
Authorized Official - Phone:813-262-0471
Mailing Address - Street 1:403 LITHIA PINECREST RD
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-6138
Mailing Address - Country:US
Mailing Address - Phone:813-262-0471
Mailing Address - Fax:813-438-8930
Practice Address - Street 1:403 LITHIA PINECREST RD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-6138
Practice Address - Country:US
Practice Address - Phone:813-262-0471
Practice Address - Fax:813-438-8930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-15
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 0002343101YM0800X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty