Provider Demographics
NPI:1518015700
Name:BRICKEY, VERLON COY JR (PHD, LMHC, CAP)
Entity type:Individual
Prefix:MR
First Name:VERLON
Middle Name:COY
Last Name:BRICKEY
Suffix:JR
Gender:M
Credentials:PHD, LMHC, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2520 UNIVERSITY BLVD W
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32217-2004
Mailing Address - Country:US
Mailing Address - Phone:904-733-1444
Mailing Address - Fax:904-733-5258
Practice Address - Street 1:2520 UNIVERSITY BLVD W
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32217-2004
Practice Address - Country:US
Practice Address - Phone:904-733-1444
Practice Address - Fax:904-733-5258
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH5088101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional