Provider Demographics
NPI:1952089294
Name:PJANIC, BRANDY-PAULA MICHELLE (LCSWA)
Entity Type:Individual
Prefix:
First Name:BRANDY-PAULA
Middle Name:MICHELLE
Last Name:PJANIC
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:PJANIC
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:305 COMMERCE AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-2971
Mailing Address - Country:US
Mailing Address - Phone:252-773-0195
Mailing Address - Fax:252-733-0214
Practice Address - Street 1:305 COMMERCE AVE STE 102
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-2971
Practice Address - Country:US
Practice Address - Phone:252-773-0195
Practice Address - Fax:252-773-0214
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-07
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0191191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical