Provider Demographics
NPI:1033807284
Name:BRENNEMAN, LISA ANNE (LMHC)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:ANNE
Last Name:BRENNEMAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2367 SEVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-2970
Mailing Address - Country:US
Mailing Address - Phone:772-559-5641
Mailing Address - Fax:
Practice Address - Street 1:MENTAL HEALTH ASSOCIATION IN INDIAN RIVER COUNTY
Practice Address - Street 2:820 37TH PLACE
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960
Practice Address - Country:US
Practice Address - Phone:772-559-5641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-26
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH21842101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health