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General NPI Number Information
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NPI Number | 1891950754
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Entity Type | Individual
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Provider Name | BRIGETTE D PENDER LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/21/2008
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 13403 N GOVERNMENT WAY STE 102
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City | HAYDEN
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State | ID
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Zip | 83835-8906
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Country | US
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Telephone | 208-719-1030
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Fax |
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Provider Business Mailing Address
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Address Line | 13403 N GOVERNMENT WAY STE 102
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City | HAYDEN
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State | ID
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Zip | 83835-8906
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Country | US
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Telephone | 208-719-1030
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW21841
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LICSW1141914
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LW60490721
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2025030406
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License Number State | MO
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