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General NPI Number Information
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NPI Number | 1356895692
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Entity Type | Individual
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Provider Name | RENA BRISENTINE MS LPC LMHC CST
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Gender | Female
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Dates
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Enumeration Date | 08/03/2016
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Last Update Date | 09/26/2023
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Provider Practice Location Address
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Address Line | 163 18TH AVE # B
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City | SEATTLE
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State | WA
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Zip | 98122-5719
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Country | US
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Telephone | 907-931-0603
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Fax |
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Provider Business Mailing Address
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Address Line | 163 18TH AVE # B
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City | SEATTLE
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State | WA
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Zip | 98122-5719
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Country | US
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Telephone | 360-280-3673
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 61072814
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License Number State | WA
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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 | 106280
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License Number State | AK
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 106280
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License Number State | CO
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