Provider Demographics
NPI:1477853182
Name:BRANDNER, MARCY SWIATEK (MFT)
Entity Type:Individual
Prefix:
First Name:MARCY
Middle Name:SWIATEK
Last Name:BRANDNER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:MARCY
Other - Middle Name:
Other - Last Name:SWIATEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFT
Mailing Address - Street 1:18928 RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:SONOMA
Mailing Address - State:CA
Mailing Address - Zip Code:95476-4536
Mailing Address - Country:US
Mailing Address - Phone:775-772-9790
Mailing Address - Fax:
Practice Address - Street 1:19343 SONOMA HIGHWAY
Practice Address - Street 2:
Practice Address - City:SONOMA
Practice Address - State:CA
Practice Address - Zip Code:95476
Practice Address - Country:US
Practice Address - Phone:775-337-2394
Practice Address - Fax:775-337-9570
Is Sole Proprietor?:No
Enumeration Date:2010-10-27
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NV01240106H00000X
COMFT.0001729106H00000X
CALMFT111964106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health