Provider Demographics
NPI:1518386424
Name:BRANDT, TARYN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:TARYN
Middle Name:
Last Name:BRANDT
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 CHERRY LN
Mailing Address - Street 2:
Mailing Address - City:LAKE PLACID
Mailing Address - State:NY
Mailing Address - Zip Code:12946-6626
Mailing Address - Country:US
Mailing Address - Phone:860-866-7676
Mailing Address - Fax:
Practice Address - Street 1:196 OLD MILITARY RD
Practice Address - Street 2:
Practice Address - City:LAKE PLACID
Practice Address - State:NY
Practice Address - Zip Code:12946-1940
Practice Address - Country:US
Practice Address - Phone:860-866-7676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-08
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TE1100XBehavioral Health & Social Service ProvidersPsychologistExercise & Sports