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General NPI Number Information
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NPI Number | 1013075803
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Entity Type | Individual
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Provider Name | LEONARD ANTHONY BRISENDINE LPC
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Gender | Male
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1717 K ST NW SUITE 600
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City | WASHINGTON
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State | DC
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Zip | 20036-5346
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Country | US
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Telephone | 202-236-0911
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Fax |
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Provider Business Mailing Address
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Address Line | 1202 S WASHINGTON ST #318
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City | ALEXANDRIA
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State | VA
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Zip | 22314-4406
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Country | US
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Telephone | 202-236-0911
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PRC13861
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701003387
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License Number State | VA
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