Provider Demographics
NPI:1003783044
Name:BRANDT, JENNIFER (LMSW-C)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:BRANDT
Suffix:
Gender:F
Credentials:LMSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 5TH AVE S
Mailing Address - Street 2:
Mailing Address - City:ESCANABA
Mailing Address - State:MI
Mailing Address - Zip Code:49829-1204
Mailing Address - Country:US
Mailing Address - Phone:906-233-4276
Mailing Address - Fax:906-786-0660
Practice Address - Street 1:3409 LUDINGTON ST STE 103
Practice Address - Street 2:
Practice Address - City:ESCANABA
Practice Address - State:MI
Practice Address - Zip Code:49829-4213
Practice Address - Country:US
Practice Address - Phone:906-789-4040
Practice Address - Fax:906-789-4044
Is Sole Proprietor?:No
Enumeration Date:2025-10-23
Last Update Date:2025-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011204981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical