Provider Demographics
NPI:1699251272
Name:BRENNEMAN, HALEIGH FAYE (LCPC)
Entity type:Individual
Prefix:MS
First Name:HALEIGH
Middle Name:FAYE
Last Name:BRENNEMAN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18910 MARYLAND HWY
Mailing Address - Street 2:
Mailing Address - City:SWANTON
Mailing Address - State:MD
Mailing Address - Zip Code:21561-1426
Mailing Address - Country:US
Mailing Address - Phone:240-522-5424
Mailing Address - Fax:
Practice Address - Street 1:932 NATIONAL HWY
Practice Address - Street 2:
Practice Address - City:LAVALE
Practice Address - State:MD
Practice Address - Zip Code:21502-7380
Practice Address - Country:US
Practice Address - Phone:240-522-5424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-17
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC10800101YP2500X, 101YP2500X
MDADT1674101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)