Provider Demographics
NPI:1780019547
Name:MCNALLY, BRENDAN (MA)
Entity type:Individual
Prefix:MR
First Name:BRENDAN
Middle Name:
Last Name:MCNALLY
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1665 FOSTER AVE APT B
Mailing Address - Street 2:
Mailing Address - City:ARCATA
Mailing Address - State:CA
Mailing Address - Zip Code:95521-5353
Mailing Address - Country:US
Mailing Address - Phone:650-733-3245
Mailing Address - Fax:
Practice Address - Street 1:427 F ST STE 223
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-1041
Practice Address - Country:US
Practice Address - Phone:650-733-3245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist