Provider Demographics
NPI:1679056725
Name:JAMES, BRENDA A (MED, LPC)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:A
Last Name:JAMES
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 COUSINS CT
Mailing Address - Street 2:
Mailing Address - City:WETUMPKA
Mailing Address - State:AL
Mailing Address - Zip Code:36092-8223
Mailing Address - Country:US
Mailing Address - Phone:334-399-1217
Mailing Address - Fax:334-460-7619
Practice Address - Street 1:48 COUSINS CT
Practice Address - Street 2:
Practice Address - City:WETUMPKA
Practice Address - State:AL
Practice Address - Zip Code:36092-8223
Practice Address - Country:US
Practice Address - Phone:334-399-1217
Practice Address - Fax:334-460-7619
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-13
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3154101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional