Provider Demographics
NPI:1356762561
Name:EDLUND, BRANDY JUNE (MS, LPC, NCC)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:JUNE
Last Name:EDLUND
Suffix:
Gender:F
Credentials:MS, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 E 27TH ST
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-2817
Mailing Address - Country:US
Mailing Address - Phone:307-751-4808
Mailing Address - Fax:
Practice Address - Street 1:106 E 27TH ST
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-2817
Practice Address - Country:US
Practice Address - Phone:307-751-4808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-16
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLPC-1504101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health