Provider Demographics
NPI:1104439728
Name:ANDREA BRENNAN LICENSED MENTAL HEALTH COUNSELING, PLLC
Entity type:Organization
Organization Name:ANDREA BRENNAN LICENSED MENTAL HEALTH COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRENNAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, CRC, CCTP
Authorized Official - Phone:585-880-9052
Mailing Address - Street 1:245 OLD MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-3548
Mailing Address - Country:US
Mailing Address - Phone:585-880-9052
Mailing Address - Fax:
Practice Address - Street 1:245 OLD MEADOW DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-3548
Practice Address - Country:US
Practice Address - Phone:585-880-9052
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-24
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health