Provider Demographics
NPI:1801949862
Name:PATEMAN, BRENDA (LCSW, LCADC)
Entity type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:
Last Name:PATEMAN
Suffix:
Gender:F
Credentials:LCSW, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 W CLIFF ST
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-1901
Mailing Address - Country:US
Mailing Address - Phone:908-704-8591
Mailing Address - Fax:908-722-4142
Practice Address - Street 1:17 W CLIFF ST
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-1901
Practice Address - Country:US
Practice Address - Phone:908-704-8591
Practice Address - Fax:908-722-4142
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00040300101YA0400X
NJSC081411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP2472122OtherOXFORD PROVIDER NUMBER