MEDICARE: BRENDA J. FLYNN MSW, ACSW, 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
1	1041C0700X	Clinical Social Worker	004418	MO

General Provider Information

NPI Number	:	1952318123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDA J. FLYNN MSW, ACSW, LCSW

Provider Business Mailing Address
First Line	:	141 N MERAMEC AVE
Second Line	:	SUITE 210
City	:	SAINT LOUIS
State	:	MO
Zip	:	63105-3750
Country	:	US
Telephone Number	:	314-727-4646
Fax Number	:

Provider Business Practice Location Address
First Line	:	141 N MERAMEC AVE
Second Line	:	SUITE 210
City	:	SAINT LOUIS
State	:	MO
Zip	:	63105-3750
Country	:	US
Telephone Number	:	314-727-4646
Fax Number	:

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

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	07/08/2007

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