Provider Demographics
NPI:1578074795
Name:BRILEY, DREAMA L (RMHCI)
Entity Type:Individual
Prefix:MISS
First Name:DREAMA
Middle Name:L
Last Name:BRILEY
Suffix:
Gender:F
Credentials:RMHCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 MCGUIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:INDIAN HARBOUR BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32937-4006
Mailing Address - Country:US
Mailing Address - Phone:860-805-6128
Mailing Address - Fax:
Practice Address - Street 1:1227 S PATRICK DR STE 108
Practice Address - Street 2:
Practice Address - City:SATELLITE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-3969
Practice Address - Country:US
Practice Address - Phone:321-773-1111
Practice Address - Fax:321-773-1692
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-15
Last Update Date:2017-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL15295101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)