Provider Demographics
NPI:1801679758
Name:BRANDON, TODD CHRISTOPHER (LPC)
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:CHRISTOPHER
Last Name:BRANDON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:898 E 9TH CT
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:OR
Mailing Address - Zip Code:97127-9615
Mailing Address - Country:US
Mailing Address - Phone:971-570-7569
Mailing Address - Fax:
Practice Address - Street 1:898 E 9TH CT
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:OR
Practice Address - Zip Code:97127-9615
Practice Address - Country:US
Practice Address - Phone:971-570-7569
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-15
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC2499101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty