Provider Demographics
NPI:1235778077
Name:BRENNER, DANIELA GUIMARAES (LPC)
Entity Type:Individual
Prefix:
First Name:DANIELA
Middle Name:GUIMARAES
Last Name:BRENNER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:DANIELA
Other - Middle Name:CRISTINA
Other - Last Name:GUIMARAES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:807 E WASHINGTON ST STE 150
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-3339
Mailing Address - Country:US
Mailing Address - Phone:330-241-4444
Mailing Address - Fax:
Practice Address - Street 1:807 E WASHINGTON ST STE 150
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-3339
Practice Address - Country:US
Practice Address - Phone:330-241-4444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-26
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1901848101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)