Provider Demographics
NPI:1376910059
Name:WILLEY, BRIE-ANNA MICHELLE (LMHC, CRC)
Entity Type:Individual
Prefix:
First Name:BRIE-ANNA
Middle Name:MICHELLE
Last Name:WILLEY
Suffix:
Gender:F
Credentials:LMHC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2063
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34220-2063
Mailing Address - Country:US
Mailing Address - Phone:941-807-2670
Mailing Address - Fax:855-240-3641
Practice Address - Street 1:600 8TH AVE W STE 200
Practice Address - Street 2:
Practice Address - City:PALMETTO
Practice Address - State:FL
Practice Address - Zip Code:34221-5162
Practice Address - Country:US
Practice Address - Phone:941-757-8597
Practice Address - Fax:855-240-3641
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-28
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH12927101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health