Brenner, George B

Brenner, George B is an individual health care provider with primary practice located at 5470 E 16Th Street , Indianapolis IN 46218-4861. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Marriage & Family Therapist, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Brenner, George B can be contacted via phone (317) 355-5009.

Contact Information

Primary practice address
5470 E 16Th Street Indianapolis IN 46218-4861
Phone: (317) 355-5009
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 35000397A Indiana
Behavioral Health & Social Service Providers / Clinical 1041C0700X 34002846A Indiana

Profile Details

NPI number 1689639189
LBN Legal business name Brenner, George B
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 18th, 2006
Last updated Oct 22nd, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689639189 NPPES
Indiana MEDICAID 100270530A
Indiana Other 000000386704

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