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NPI Code Detail

MEDICARE: BRANDY ENNEKING

MEDICARE:   BRANDY  ENNEKING
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselorLAC 14549AZ
2101YM0800XMental Health CounselorLCPC-03104KS
3101YM0800XMental Health CounselorLPC-17039AZ

General Provider Information

NPI Number : 1154715076
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRANDY ENNEKING
Provider Business Mailing Address
First Line : 5120 SW 31ST ST
Second Line :
City : TOPEKA
State : KS
Zip : 66614-3902
Country : US
Telephone Number : 520-850-7283
Fax Number :
Provider Business Practice Location Address
First Line : 5120 SW 31ST ST
Second Line :
City : TOPEKA
State : KS
Zip : 66614-3902
Country : US
Telephone Number : 520-261-1366
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2015
Last Update Date : 04/27/2023

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Directions to “ BRANDY ENNEKING ” Practice Location

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