Provider Demographics
NPI:1689245581
Name:BRANDENBURG, HEATHER (CSW)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:BRANDENBURG
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 N MAYSVILLE ST
Mailing Address - Street 2:
Mailing Address - City:MT STERLING
Mailing Address - State:KY
Mailing Address - Zip Code:40353-1315
Mailing Address - Country:US
Mailing Address - Phone:859-498-9892
Mailing Address - Fax:859-498-0316
Practice Address - Street 1:37 N MAYSVILLE ST
Practice Address - Street 2:
Practice Address - City:MT STERLING
Practice Address - State:KY
Practice Address - Zip Code:40353-1315
Practice Address - Country:US
Practice Address - Phone:859-498-9892
Practice Address - Fax:859-498-0316
Is Sole Proprietor?:No
Enumeration Date:2021-07-02
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor