Provider Demographics
NPI:1942853791
Name:ZEDLITZ, BRENDA VEACH (LCSW)
Entity Type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:VEACH
Last Name:ZEDLITZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5411 S BENT TREE DR
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-8647
Mailing Address - Country:US
Mailing Address - Phone:479-426-6083
Mailing Address - Fax:
Practice Address - Street 1:5411 S BENT TREE DR
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-8647
Practice Address - Country:US
Practice Address - Phone:479-426-6083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-22
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR6320-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical