Provider Demographics
NPI:1073829313
Name:BRANDOW, FRED RICHARD (LPC ,LSCSW)
Entity Type:Individual
Prefix:MR
First Name:FRED
Middle Name:RICHARD
Last Name:BRANDOW
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Gender:M
Credentials:LPC ,LSCSW
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Mailing Address - Street 1:10500 BARKLEY ST
Mailing Address - Street 2:SUITE 216
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-1811
Mailing Address - Country:US
Mailing Address - Phone:913-383-3337
Mailing Address - Fax:913-381-2547
Practice Address - Street 1:10500 BARKLEY ST
Practice Address - Street 2:SUITE 216
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-1811
Practice Address - Country:US
Practice Address - Phone:913-383-3337
Practice Address - Fax:913-381-2547
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-24
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS13411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical