Provider Demographics
NPI:1275698474
Name:BRENDIS, MARY ELIZABETH (MS LMHP)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:ELIZABETH
Last Name:BRENDIS
Suffix:
Gender:F
Credentials:MS LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11920 BURT ST
Mailing Address - Street 2:SUITE #190 ALLIANCE COUNSELING CENTER LLP
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154
Mailing Address - Country:US
Mailing Address - Phone:402-965-4004
Mailing Address - Fax:402-965-4232
Practice Address - Street 1:11920 BURT ST
Practice Address - Street 2:SUITE #190
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154
Practice Address - Country:US
Practice Address - Phone:402-965-4004
Practice Address - Fax:402-965-4232
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1695101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025086600Medicaid