Provider Demographics
NPI:1588240188
Name:ANDERSON, BRENDA-LEE M (MSW, CSWA)
Entity Type:Individual
Prefix:
First Name:BRENDA-LEE
Middle Name:M
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MSW, CSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 E 7TH AVE STE A220
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3090
Mailing Address - Country:US
Mailing Address - Phone:541-378-8359
Mailing Address - Fax:
Practice Address - Street 1:211 E 7TH AVE STE A220
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3090
Practice Address - Country:US
Practice Address - Phone:541-378-8359
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-23
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORA12170104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker