MEDICARE: BRANDON E DRUMMOND LMHC

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
1	101YP2500X	Professional Counselor	010067	NY

General Provider Information

NPI Number	:	1598399164
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDON E DRUMMOND LMHC

Provider Business Mailing Address
First Line	:	417 DOVE ST
Second Line	:
City	:	DUNKIRK
State	:	NY
Zip	:	14048-2030
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	42 LAKE ST STE D
Second Line	:
City	:	HAMBURG
State	:	NY
Zip	:	14075-4937
Country	:	US
Telephone Number	:	716-397-6633
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2020
Last Update Date	:	02/23/2020

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