Provider Demographics
NPI:1568595361
Name:FEW, BRENDA GAIL (LCPC, MA, NCC)
Entity Type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:GAIL
Last Name:FEW
Suffix:
Gender:F
Credentials:LCPC, MA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2882 ADRIENNE WAY
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32163-6015
Mailing Address - Country:US
Mailing Address - Phone:352-446-6774
Mailing Address - Fax:
Practice Address - Street 1:2882 ADRIENNE WAY
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32163-6015
Practice Address - Country:US
Practice Address - Phone:352-446-6774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC3480302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization