DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: DR. EDWIN BRENNAN PHD, LP

MEDICARE: DR. EDWIN BRENNAN PHD, LP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor6401014593MI
2103TH0100XHealth Service Psychologist1544LA
3103TH0100XHealth Service Psychologist

General Provider Information

NPI Number : 1295196152
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EDWIN BRENNAN PHD, LP
Provider Business Mailing Address
First Line : FORT POLK VA OUTPATIENT CLINIC
Second Line : 3353 UNIVERSITY PARKWAY
City : LEESVILLE, LA 71446
State : LA
Zip : 71446
Country : US
Telephone Number : 373-392-3800
Fax Number :
Provider Business Practice Location Address
First Line : 3353 UNIVERSITY PKWY
Second Line :
City : LEESVILLE
State : LA
Zip : 71446-9041
Country : US
Telephone Number : 337-392-3800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2016
Last Update Date : 09/27/2022

Similar Medicare Providers

1750342507 — DR. JAMES D PATTERSON MD
Practice Location Address:
3353 UNIVERSITY PKWY
LEESVILLE, LA
71446-9041
Practice Phone: 337-392-3800
Practice Fax:
1225258122 — AMARIS NAVEDO M.D.
Practice Location Address:
3353 UNIVERSITY PKWY , FORT POLK VA COMMUNITY BASED OUTPATIENT CLINIC
LEESVILLE, LA
71446-9041
Practice Phone: 337-392-3800
Practice Fax: 337-392-3890
1245513506 — ALEXANDRIA VAMC
Practice Location Address:
3353 UNIVERSITY PKWY
LEESVILLE, LA
71446-9041
Practice Phone: 615-355-3451
Practice Fax:
1982004594 — LAKEN LEWIS
Practice Location Address:
3353 UNIVERSITY PKWY
LEESVILLE, LA
71446-9041
Practice Phone: 337-392-3815
Practice Fax: 337-392-3890
1053709063 — AMIE BLACKBURN LCSW
Practice Location Address:
3353 UNIVERSITY PKWY
LEESVILLE, LA
71446-9041
Practice Phone: 337-392-3800
Practice Fax:
1699433227 — JESSICA JULIAN FNP-BC
Practice Location Address:
3353 UNIVERSITY PKWY
LEESVILLE, LA
71446-9041
Practice Phone: 373-923-8003
Practice Fax:

Directions to “ DR. EDWIN BRENNAN PHD, LP” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.