Provider Demographics
NPI:1912108812
Name:BRIX, JAMES ALAN (D MIN, L P C)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ALAN
Last Name:BRIX
Suffix:
Gender:M
Credentials:D MIN, L P C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2803 SONOMA WAY
Mailing Address - Street 2:
Mailing Address - City:VIERA
Mailing Address - State:FL
Mailing Address - Zip Code:32955-5179
Mailing Address - Country:US
Mailing Address - Phone:321-636-5986
Mailing Address - Fax:
Practice Address - Street 1:170 TOWNSHIP LINE RD
Practice Address - Street 2:BUILDING A, 2ND FLOOR
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-3867
Practice Address - Country:US
Practice Address - Phone:908-359-3269
Practice Address - Fax:908-359-0274
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00291700101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ37PC00291700OtherLICENSED PROFESSIONAL COU