Provider Demographics
NPI:1407868110
Name:MICHAEL, BRENDA K (LPC)
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:K
Last Name:MICHAEL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1430
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22803-1430
Mailing Address - Country:US
Mailing Address - Phone:540-564-5636
Mailing Address - Fax:540-433-4123
Practice Address - Street 1:644 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-3750
Practice Address - Country:US
Practice Address - Phone:540-564-5629
Practice Address - Fax:540-433-4338
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701000830101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA084552MOtherSENTARA PROVIDER NUMBER
VA1164637518OtherGROUP NPI NUMBER
VA11426850OtherCAQH PROVIDER NUMBER
VA177051OtherANTHEM PROVIDER NUMBER
VA2240808OtherCIGNA PROVIDER NUMBER
VA432609OtherVALUE OPTIONS PROVIDER NO
VA010069593Medicaid
VA251026OtherCOMPSYCH PROVIDER NUMBER
VAC05754OtherMEDICARE GROUP NUMBER