Provider Demographics
NPI:1003319484
Name:BRENTLINGER, BRIAN THOMAS (LPCC)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:THOMAS
Last Name:BRENTLINGER
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 21
Mailing Address - Street 2:
Mailing Address - City:GLENCOE
Mailing Address - State:KY
Mailing Address - Zip Code:41046-0021
Mailing Address - Country:US
Mailing Address - Phone:859-308-2246
Mailing Address - Fax:
Practice Address - Street 1:113 E HOWARD STREET
Practice Address - Street 2:
Practice Address - City:GLENCOE
Practice Address - State:KY
Practice Address - Zip Code:41046-0021
Practice Address - Country:US
Practice Address - Phone:859-308-2246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-13
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY278529101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health