Provider Demographics
NPI:1063874998
Name:BITTERMAN, BRENDA KAY (LGSW)
Entity type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:KAY
Last Name:BITTERMAN
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:BRENDA
Other - Middle Name:KAY
Other - Last Name:GRISHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LGSW
Mailing Address - Street 1:422 COX BLVD
Mailing Address - Street 2:
Mailing Address - City:SHEFFIELD
Mailing Address - State:AL
Mailing Address - Zip Code:35660-4000
Mailing Address - Country:US
Mailing Address - Phone:256-381-6101
Mailing Address - Fax:
Practice Address - Street 1:422 COX BLVD
Practice Address - Street 2:
Practice Address - City:SHEFFIELD
Practice Address - State:AL
Practice Address - Zip Code:35660-4000
Practice Address - Country:US
Practice Address - Phone:256-381-6101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-21
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3649G104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker