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General NPI Number Information
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NPI Number | 1073907002
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Entity Type | Organization
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Legal Business Name | BRENDA MCILNAY, PC
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Dates
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Enumeration Date | 03/27/2015
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Last Update Date | 03/27/2015
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Provider Practice Location Address
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Address Line | 108 N. 49TH STREET SUITE 208
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City | OMAHA
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State | NE
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Zip | 68132-3147
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Country | US
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Telephone | 402-889-2070
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Fax | 402-504-3369
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Provider Business Mailing Address
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Address Line | 108 N. 49TH STREET SUITE 208
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City | OMAHA
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State | NE
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Zip | 68132-3147
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Country | US
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Telephone | 402-889-2070
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Fax | 402-504-3369
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRENDA SUE MCILNAY
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Credential | LCSW, LIMHP
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Telephone | 402-889-2070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 142
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License Number State | NE
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