Provider Demographics
NPI:1891021168
Name:BRANTNER, PETER L (LMHC)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:L
Last Name:BRANTNER
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2929 WESTOWN PARKWAY
Mailing Address - Street 2:STE. 110 DES MOINES PASTORAL COUNSELING CENTER
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266
Mailing Address - Country:US
Mailing Address - Phone:515-274-4006
Mailing Address - Fax:515-255-5697
Practice Address - Street 1:2929 WESTOWN PARKWAY
Practice Address - Street 2:STE. 110 DES MOINES PASTORAL COUNSELING CENTER
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266
Practice Address - Country:US
Practice Address - Phone:515-274-4006
Practice Address - Fax:515-255-5697
Is Sole Proprietor?:No
Enumeration Date:2009-10-21
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA0012281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical