Healthcare Provider Details

I. General information

NPI: 1659290559
Provider Name (Legal Business Name): BROOKE JORDAN BARENDSEN MS CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 STEPHENSON AVE
SAVANNAH GA
31405-5920
US

IV. Provider business mailing address

549 E PARK AVE UNIT B
SAVANNAH GA
31401-6516
US

V. Phone/Fax

Practice location:
  • Phone: 912-667-6443
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number30003871
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP013587
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: