Provider Demographics
NPI:1073907002
Name:BRENDA MCILNAY, PC
Entity Type:Organization
Organization Name:BRENDA MCILNAY, PC
Other - Org Name:COGNITIVE BEHAVIORAL THERAPY ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:MCILNAY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LIMHP
Authorized Official - Phone:402-889-2070
Mailing Address - Street 1:108 N. 49TH STREET
Mailing Address - Street 2:SUITE 208
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68132-3147
Mailing Address - Country:US
Mailing Address - Phone:402-889-2070
Mailing Address - Fax:402-504-3369
Practice Address - Street 1:108 N. 49TH STREET
Practice Address - Street 2:SUITE 208
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68132-3147
Practice Address - Country:US
Practice Address - Phone:402-889-2070
Practice Address - Fax:402-504-3369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-27
Last Update Date:2015-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty