Provider Demographics
NPI:1891745048
Name:MCILNAY, BRENDA S (LIMHP)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:S
Last Name:MCILNAY
Suffix:
Gender:F
Credentials:LIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 N 49TH ST STE 210
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68132-3147
Mailing Address - Country:US
Mailing Address - Phone:402-981-8722
Mailing Address - Fax:402-504-3369
Practice Address - Street 1:108 N 49TH ST STE 210
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68132-3147
Practice Address - Country:US
Practice Address - Phone:402-981-8722
Practice Address - Fax:402-504-3369
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE21381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47078557539Medicaid
NE275455Medicare ID - Type Unspecified
NEP40027Medicare UPIN