1407044613 NPI number — MS. BARBARA ANN BRISSENDEN LMHC, LMT

Table of content: MS. BARBARA ANN BRISSENDEN LMHC, LMT (NPI 1407044613)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407044613 NPI number — MS. BARBARA ANN BRISSENDEN LMHC, LMT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BRISSENDEN
Provider First Name:
BARBARA
Provider Middle Name:
ANN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LMHC, LMT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BRISSENDEN
Provider Other First Name:
BARBARA
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1407044613
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/10/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
590 6TH ST S
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAFETY HARBOR
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34695-4236
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-791-4954
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
126 3RD AVE N
Provider Second Line Business Practice Location Address:
SUITE 205
Provider Business Practice Location Address City Name:
SAFETY HARBOR
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34695-3667
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-791-4954
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/12/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  MH 9249 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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