Provider Demographics
NPI:1467067546
Name:WIESSNER, BRYNN (LCSW)
Entity Type:Individual
Prefix:
First Name:BRYNN
Middle Name:
Last Name:WIESSNER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17478 E RICE CIR UNIT C
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80015-2793
Mailing Address - Country:US
Mailing Address - Phone:651-270-7917
Mailing Address - Fax:
Practice Address - Street 1:11892 HILLTOP RD
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-6019
Practice Address - Country:US
Practice Address - Phone:303-817-6531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-15
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0009922918104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker