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General NPI Number Information
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NPI Number | 1598229684
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Entity Type | Individual
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Provider Name | KATY BRANDENBURG LMHC
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Gender | Female
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Dates
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Enumeration Date | 01/23/2019
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Last Update Date | 07/11/2023
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Provider Practice Location Address
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Address Line | 32 PEA PL
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City | KULA
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State | HI
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Zip | 96790-8302
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Country | US
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Telephone | 831-425-8132
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1094
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City | MAKAWAO
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State | HI
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Zip | 96768-1094
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Country | US
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Telephone | 805-705-9671
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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 | 109565
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MHC-960
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License Number State | HI
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