Provider Demographics
NPI:1205247731
Name:BRADLEY VAN HOEK PSYCHOTHERAPY PLLC
Entity type:Organization
Organization Name:BRADLEY VAN HOEK PSYCHOTHERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:VAN HOEK
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, CAP
Authorized Official - Phone:561-281-1693
Mailing Address - Street 1:205 WORTH AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33480-4606
Mailing Address - Country:US
Mailing Address - Phone:561-281-1693
Mailing Address - Fax:
Practice Address - Street 1:205 WORTH AVE.
Practice Address - Street 2:SUITE 201
Practice Address - City:PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33480
Practice Address - Country:US
Practice Address - Phone:561-281-1693
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-19
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10473251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health