Provider Demographics
NPI:1386202372
Name:BRENDA E STEVE MA LP INCORPORATED
Entity Type:Organization
Organization Name:BRENDA E STEVE MA LP INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:E
Authorized Official - Last Name:STEVE
Authorized Official - Suffix:
Authorized Official - Credentials:MA LP
Authorized Official - Phone:612-750-9072
Mailing Address - Street 1:52 GROVELAND TER UNIT 208
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55403-1119
Mailing Address - Country:US
Mailing Address - Phone:612-750-9072
Mailing Address - Fax:
Practice Address - Street 1:212 RIDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55403-3507
Practice Address - Country:US
Practice Address - Phone:612-872-8400
Practice Address - Fax:612-872-1250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-04
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty