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NPI 1417675497

NPI 1417675497 : BRANDI MUNDIE LCPC : BALTIMORE, MD

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General NPI Number Information
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    NPI Number           |    1417675497
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    Entity Type          |    Individual 
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    Provider Name        |    BRANDI MUNDIE LCPC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/16/2022
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    Last Update Date     |    09/11/2025
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Provider Practice Location Address
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    Address Line         |    4128 HAYWARD AVE 
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    City                 |    BALTIMORE
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    State                |    MD
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    Zip                  |    21215-4340
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    Country              |    US
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    Telephone            |    410-357-6599
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4128 HAYWARD AVE 
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    City                 |    BALTIMORE
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    State                |    MD
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    Zip                  |    21215-4340
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    Country              |    US
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    Telephone            |    410-357-6599
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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       |    LC15942
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    License Number State |    MD
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