Provider Demographics
NPI:1962633958
Name:MANLEY, BRANDY C (LMHC)
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:C
Last Name:MANLEY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:BRANDY
Other - Middle Name:
Other - Last Name:WHYTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCPC
Mailing Address - Street 1:3510 BRENBROOK DR
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-4902
Mailing Address - Country:US
Mailing Address - Phone:585-705-0626
Mailing Address - Fax:716-242-0063
Practice Address - Street 1:3510 BRENBROOK DR
Practice Address - Street 2:
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21133-4902
Practice Address - Country:US
Practice Address - Phone:585-705-0626
Practice Address - Fax:716-242-0063
Is Sole Proprietor?:No
Enumeration Date:2009-08-07
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MDLC2450101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health