Provider Demographics
NPI:1609472984
Name:STENZEL, BRANDON PAUL (MA, LPCC)
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:PAUL
Last Name:STENZEL
Suffix:
Gender:M
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 DONOVAN DR
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55744-4128
Mailing Address - Country:US
Mailing Address - Phone:651-564-1075
Mailing Address - Fax:
Practice Address - Street 1:2900 E BELTLINE STE 16
Practice Address - Street 2:
Practice Address - City:HIBBING
Practice Address - State:MN
Practice Address - Zip Code:55746-2345
Practice Address - Country:US
Practice Address - Phone:218-969-9796
Practice Address - Fax:218-263-6789
Is Sole Proprietor?:No
Enumeration Date:2020-12-10
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2680101YP2500X
MNCC02680101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional