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General NPI Number Information
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NPI Number | 1609960616
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Entity Type | Individual
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Provider Name | TERRENCE TIERNEY BRENNAN L.C.S.W., A.C.S.W.
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Gender | Male
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6601 VENTNOR AVENUE SUITE# 105
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City | VENTNOR
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State | NJ
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Zip | 08406
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Country | US
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Telephone | 609-487-8387
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Fax | 609-487-8910
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Provider Business Mailing Address
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Address Line | 6601 VENTNOR AVENUE SUITE# 105
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City | VENTNOR
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State | NJ
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Zip | 08406
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Country | US
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Telephone | 609-487-8387
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Fax | 609-487-8910
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 07044
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License Number State | MD
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