Provider Demographics
NPI:1457908121
Name:BRENNER, STEVEN M (MS, LMHC, NCC, CCMHC)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:M
Last Name:BRENNER
Suffix:
Gender:M
Credentials:MS, LMHC, NCC, CCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 N FEDERAL HWY STE 306
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-5183
Mailing Address - Country:US
Mailing Address - Phone:561-573-6710
Mailing Address - Fax:
Practice Address - Street 1:4400 N FEDERAL HWY STE 306
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-5183
Practice Address - Country:US
Practice Address - Phone:561-573-6710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-19
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH-16710101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional