Provider Demographics
NPI:1134260672
Name:BRENNAN, JANICE MARY (LMSW)
Entity type:Individual
Prefix:MS
First Name:JANICE
Middle Name:MARY
Last Name:BRENNAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 695
Mailing Address - Street 2:
Mailing Address - City:FREELAND
Mailing Address - State:MI
Mailing Address - Zip Code:48623-0695
Mailing Address - Country:US
Mailing Address - Phone:989-497-2500
Mailing Address - Fax:
Practice Address - Street 1:2838 AUTOMOTIVE CTR
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-1220
Practice Address - Country:US
Practice Address - Phone:989-790-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010209801041C0700X, 1041C0700X
MI4101005448106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist