Provider Demographics
NPI:1568476992
Name:CRUESOE, BRANDY CHRISTINA (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:BRANDY
Middle Name:CHRISTINA
Last Name:CRUESOE
Suffix:
Gender:F
Credentials:MSW, LCSW
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 18924
Mailing Address - Street 2:
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63105-3712
Mailing Address - Country:US
Mailing Address - Phone:314-368-2575
Mailing Address - Fax:
Practice Address - Street 1:225 S MERAMEC AVE STE 404
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63105-3511
Practice Address - Country:US
Practice Address - Phone:314-368-2575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-29
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical