Provider Demographics
NPI:1871225243
Name:BRANDT, TERESA (MSW)
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:
Last Name:BRANDT
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MISS
Other - First Name:TERESA
Other - Middle Name:
Other - Last Name:COTTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:404 ORLEANS LN
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60193-2545
Mailing Address - Country:US
Mailing Address - Phone:331-214-2649
Mailing Address - Fax:
Practice Address - Street 1:111 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-1948
Practice Address - Country:US
Practice Address - Phone:331-214-2649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-25
Last Update Date:2022-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker