Provider Demographics
NPI:1669278677
Name:PANCOAST, BRANDY (CPC-I)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:
Last Name:PANCOAST
Suffix:
Gender:F
Credentials:CPC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 CHRIS AVE
Mailing Address - Street 2:
Mailing Address - City:ELKO
Mailing Address - State:NV
Mailing Address - Zip Code:89801-4530
Mailing Address - Country:US
Mailing Address - Phone:707-601-6893
Mailing Address - Fax:
Practice Address - Street 1:610 CHRIS AVE
Practice Address - Street 2:
Practice Address - City:ELKO
Practice Address - State:NV
Practice Address - Zip Code:89801-4530
Practice Address - Country:US
Practice Address - Phone:707-601-6893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVCI5160101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional