Provider Demographics
NPI:1124372297
Name:COMER, BRENDON ROBERT (LCSW)
Entity Type:Individual
Prefix:MR
First Name:BRENDON
Middle Name:ROBERT
Last Name:COMER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 SAGE RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514
Mailing Address - Country:US
Mailing Address - Phone:919-942-4166
Mailing Address - Fax:919-942-8693
Practice Address - Street 1:205 SAGE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514
Practice Address - Country:US
Practice Address - Phone:919-942-4166
Practice Address - Fax:919-942-8693
Is Sole Proprietor?:No
Enumeration Date:2012-10-29
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0065501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical