Provider Demographics
NPI:1871857516
Name:BRINDOWSKI, GINA MARIE (LPC, SAC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:GINA
Middle Name:MARIE
Last Name:BRINDOWSKI
Suffix:
Gender:F
Credentials:LPC, SAC, NCC
Other - Prefix:
Other - First Name:GINA
Other - Middle Name:
Other - Last Name:MASULLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6416 S. HOWELL AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53154-3365
Mailing Address - Country:US
Mailing Address - Phone:414-304-5713
Mailing Address - Fax:414-304-5721
Practice Address - Street 1:6416 S. HOWELL AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53154-3365
Practice Address - Country:US
Practice Address - Phone:414-304-5713
Practice Address - Fax:414-304-5721
Is Sole Proprietor?:No
Enumeration Date:2012-06-27
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15849101YA0400X
WI5583101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)