Provider Demographics
NPI:1417025552
Name:BRANDENBURG, STEFFANI (LCSW,CASAC,CEAP)
Entity Type:Individual
Prefix:
First Name:STEFFANI
Middle Name:
Last Name:BRANDENBURG
Suffix:
Gender:F
Credentials:LCSW,CASAC,CEAP
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 17
Mailing Address - Street 2:
Mailing Address - City:KATONAH
Mailing Address - State:NY
Mailing Address - Zip Code:10536-0017
Mailing Address - Country:US
Mailing Address - Phone:914-882-8478
Mailing Address - Fax:
Practice Address - Street 1:153 E MAIN ST
Practice Address - Street 2:SUITE G
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-2317
Practice Address - Country:US
Practice Address - Phone:914-882-8478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR032767-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical