Provider Demographics
NPI:1598130312
Name:BRILYN SERVICES, INC
Entity Type:Organization
Organization Name:BRILYN SERVICES, INC
Other - Org Name:LYNN WATERS COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COUNSELOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:NALL
Authorized Official - Last Name:WATERS
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, LPC, CRC
Authorized Official - Phone:850-607-2375
Mailing Address - Street 1:PO BOX 1190
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32591-1190
Mailing Address - Country:US
Mailing Address - Phone:850-712-4039
Mailing Address - Fax:850-857-7800
Practice Address - Street 1:5101 N 12TH AVE
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8928
Practice Address - Country:US
Practice Address - Phone:850-607-2375
Practice Address - Fax:850-857-7800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-04
Last Update Date:2015-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH12465261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ06QMOtherBCBS