Provider Demographics
NPI:1386881043
Name:BRENNER, TERRY DANIEL (MS, LPCC-MHSP)
Entity type:Individual
Prefix:MR
First Name:TERRY
Middle Name:DANIEL
Last Name:BRENNER
Suffix:
Gender:M
Credentials:MS, LPCC-MHSP
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Mailing Address - Street 1:10401 LINN STATION RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-3842
Mailing Address - Country:US
Mailing Address - Phone:502-589-8600
Mailing Address - Fax:502-589-8745
Practice Address - Street 1:708 MAGAZINE ST STE 100
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40203-2043
Practice Address - Country:US
Practice Address - Phone:502-589-8926
Practice Address - Fax:502-585-4218
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-15
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNLPC0000002204101YP2500X
KY261338101YP2500X
IN39000547A101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional