=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598632119
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BRANDY ALLEN LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/20/2025
-----------------------------------------------------
Last Update Date | 10/20/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3269 19TH ST NW
-----------------------------------------------------
City | ROCHESTER
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55901-7052
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 507-251-2441
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 457 HILLSIDE DR SE
-----------------------------------------------------
City | CHATFIELD
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55923-1472
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 507-251-2441
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | BRANDY ALLEN
-----------------------------------------------------
Credential | LPCC
-----------------------------------------------------
Telephone | 507-251-2441
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------