Provider Demographics
NPI:1912499799
Name:BRENNER, ABBY (MSW, LSW)
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:
Last Name:BRENNER
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:ABBY
Other - Middle Name:
Other - Last Name:LEHMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:240 WATERFALL DR
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46516-3668
Mailing Address - Country:US
Mailing Address - Phone:574-402-1400
Mailing Address - Fax:
Practice Address - Street 1:240 WATERFALL DR
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46516-3668
Practice Address - Country:US
Practice Address - Phone:547-402-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-06
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health