Provider Demographics
NPI:1669635686
Name:TRUAX, BRENDA JEAN (LMFT)
Entity Type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:JEAN
Last Name:TRUAX
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5907 ALPINE AVENUE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46224
Mailing Address - Country:US
Mailing Address - Phone:317-441-3339
Mailing Address - Fax:317-464-9575
Practice Address - Street 1:615 N ALABAMA ST STE 320
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46204-1432
Practice Address - Country:US
Practice Address - Phone:317-634-6341
Practice Address - Fax:317-464-9575
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2017-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN35001495A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100264520Medicaid