Provider Demographics
NPI:1164418380
Name:MAY, BRENDA LEE (LCSWC)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:LEE
Last Name:MAY
Suffix:
Gender:F
Credentials:LCSWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10774 HICKORY RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044
Mailing Address - Country:US
Mailing Address - Phone:410-992-7288
Mailing Address - Fax:410-997-2880
Practice Address - Street 1:10774 HICKORY RIDGE RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044
Practice Address - Country:US
Practice Address - Phone:410-992-7288
Practice Address - Fax:410-997-2880
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD436101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
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399549 01OtherCAREFIRST BLUE CROSS MD
31492OtherALLIANCE
5119035OtherAUSHC PPO
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116891OtherAPS
85222OtherCIGNA BEHAVIORAL HEALTH