Provider Demographics
NPI:1720513930
Name:BINDER, BRANDI (MSW)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:
Last Name:BINDER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:741 W HICKORY POINT RD
Mailing Address - Street 2:
Mailing Address - City:FORSYTH
Mailing Address - State:IL
Mailing Address - Zip Code:62535-8915
Mailing Address - Country:US
Mailing Address - Phone:217-619-4248
Mailing Address - Fax:
Practice Address - Street 1:1900 E MAIN ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IL
Practice Address - Zip Code:61832-5100
Practice Address - Country:US
Practice Address - Phone:217-554-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-25
Last Update Date:2022-11-02
Deactivation Date:2021-07-09
Deactivation Code:
Reactivation Date:2022-07-13
Provider Licenses
StateLicense IDTaxonomies
IL149.0224171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical