Provider Demographics
NPI:1124838362
Name:SALVATORE, BRANDI L (LCSW)
Entity type:Individual
Prefix:
First Name:BRANDI
Middle Name:L
Last Name:SALVATORE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 MULDOON RD STE 111
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-2873
Mailing Address - Country:US
Mailing Address - Phone:907-762-8668
Mailing Address - Fax:
Practice Address - Street 1:1450 MULDOON RD STE 111
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-2873
Practice Address - Country:US
Practice Address - Phone:907-762-8668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-09
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK228766101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional