Provider Demographics
NPI:1972991024
Name:BRENDA OKYN
Entity Type:Organization
Organization Name:BRENDA OKYN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:A
Authorized Official - Last Name:OKYN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:954-614-6420
Mailing Address - Street 1:4851 W HILLSBORO BLVD
Mailing Address - Street 2:SUITE B1
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-4355
Mailing Address - Country:US
Mailing Address - Phone:954-614-6420
Mailing Address - Fax:954-977-4978
Practice Address - Street 1:4851 W HILLSBORO BLVD
Practice Address - Street 2:SUITE B1
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-4355
Practice Address - Country:US
Practice Address - Phone:954-614-6420
Practice Address - Fax:954-977-4978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-23
Last Update Date:2014-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH12619101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty