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NPI Code Detail

MEDICARE: MS. MAUREEN CECILIA BRENNAN LCSW

MEDICARE:  MS. MAUREEN CECILIA BRENNAN  LCSW
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
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1528255460
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MAUREEN CECILIA BRENNAN LCSW
Provider Business Mailing Address
First Line : 1132 SW 13TH AVENUE
Second Line :
City : PORTLAND
State : OR
Zip : 97205-1703
Country : US
Telephone Number : 503-535-3845
Fax Number : 503-223-6837
Provider Business Practice Location Address
First Line : 1132 SW 13TH AVENUE
Second Line :
City : PORTLAND
State : OR
Zip : 97205-1703
Country : US
Telephone Number : 503-535-3845
Fax Number : 503-223-6837
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2007
Last Update Date : 09/25/2007

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Directions to “ MS. MAUREEN CECILIA BRENNAN LCSW” Practice Location

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