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General NPI Number Information
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NPI Number | 1811629165
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Entity Type | Individual
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Provider Name | BRENDA MAYERHOFER LPC
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Gender | Female
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Dates
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Enumeration Date | 06/27/2022
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 15020 S RAVINIA AVE STE 27
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City | ORLAND PARK
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State | IL
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Zip | 60462-5352
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Country | US
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Telephone | 708-312-0705
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Fax |
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Provider Business Mailing Address
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Address Line | 4901 138TH PL
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City | CRESTWOOD
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State | IL
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Zip | 60418-1822
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Country | US
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Telephone | 708-513-2557
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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 | 178.021811
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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