Provider Demographics
NPI:1689776833
Name:PRICE, BRENDA SUE (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:SUE
Last Name:PRICE
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 S PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-5409
Mailing Address - Country:US
Mailing Address - Phone:301-745-1900
Mailing Address - Fax:301-745-4110
Practice Address - Street 1:113 S PROSPECT ST
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-5409
Practice Address - Country:US
Practice Address - Phone:301-745-1900
Practice Address - Fax:301-745-4110
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2012-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD083861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical