Provider Demographics
NPI:1770383671
Name:FACEY-LARCHE, BRANDY ANJULI (PMHNP)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:ANJULI
Last Name:FACEY-LARCHE
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:BRANDY
Other - Middle Name:ANJULI
Other - Last Name:BLANCHARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:848 DURAND RD
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-5192
Mailing Address - Country:US
Mailing Address - Phone:518-802-7095
Mailing Address - Fax:518-802-7095
Practice Address - Street 1:2155 NY-22B
Practice Address - Street 2:
Practice Address - City:MORRISONVILE
Practice Address - State:NY
Practice Address - Zip Code:12962
Practice Address - Country:US
Practice Address - Phone:518-563-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2970398103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily