Provider Demographics
NPI:1205002029
Name:BRENNER, HELENE G (PHD)
Entity Type:Individual
Prefix:DR
First Name:HELENE
Middle Name:G
Last Name:BRENNER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97 S MCCAIN DR
Mailing Address - Street 2:STE. B
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21703-6055
Mailing Address - Country:US
Mailing Address - Phone:301-695-5858
Mailing Address - Fax:301-607-6791
Practice Address - Street 1:97 S MCCAIN DR
Practice Address - Street 2:STE. B
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21703-6055
Practice Address - Country:US
Practice Address - Phone:301-695-5858
Practice Address - Fax:301-607-6791
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD2801103TC0700X, 103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling