Healthcare Provider Details

I. General information

NPI: 1336727361
Provider Name (Legal Business Name): BRENDAN R MCCLAFFERTY DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2021
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2960 SLEEPY HOLLOW RD
FALLS CHURCH VA
22044-2030
US

IV. Provider business mailing address

2331 YORK RD STE 100
TIMONIUM MD
21093-2246
US

V. Phone/Fax

Practice location:
  • Phone: 667-668-2566
  • Fax: 410-498-4983
Mailing address:
  • Phone: 667-668-2566
  • Fax: 410-498-4983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number5077
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberH0106702
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0102209136
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: