Provider Demographics
NPI:1255990859
Name:FINNEGAN, BRENDAN MOORE (LPCA)
Entity type:Individual
Prefix:
First Name:BRENDAN
Middle Name:MOORE
Last Name:FINNEGAN
Suffix:
Gender:M
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:895 STATE FARM RD STE 507
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-5432
Mailing Address - Country:US
Mailing Address - Phone:828-263-6287
Mailing Address - Fax:
Practice Address - Street 1:895 STATE FARM RD STE 507
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-5432
Practice Address - Country:US
Practice Address - Phone:828-263-6287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-07
Last Update Date:2019-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA12756101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor