Provider Demographics
NPI:1134452170
Name:BRENNAN, KATHERINE (LCSW)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:BRENNAN
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 1:644 PRESIDENT ST
Mailing Address - Street 2:2L
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-1120
Mailing Address - Country:US
Mailing Address - Phone:913-735-3603
Mailing Address - Fax:
Practice Address - Street 1:644 PRESIDENT ST
Practice Address - Street 2:2L
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-1120
Practice Address - Country:US
Practice Address - Phone:913-735-3603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-09
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY83963851041C0700X
MO20090265281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical