Provider Demographics
NPI:1265999742
Name:WOOD, BRIAN ANTONIO (LMHC)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:ANTONIO
Last Name:WOOD
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2709 HOPE LN W
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-1233
Mailing Address - Country:US
Mailing Address - Phone:561-777-0861
Mailing Address - Fax:
Practice Address - Street 1:6530 GRIFFIN RD
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33314-4301
Practice Address - Country:US
Practice Address - Phone:844-746-8863
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-21
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH11256101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health