MEDICARE: BRANDY ALLEN MA, LPCC

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
1	101Y00000X	Counselor	CC1424	MN
2	101YM0800X	Mental Health Counselor	CC1424	MN

General Provider Information

NPI Number	:	1164963062
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDY ALLEN MA, LPCC

Provider Business Mailing Address
First Line	:	3269 19TH ST NW
Second Line	:
City	:	ROCHESTER
State	:	MN
Zip	:	55901-7052
Country	:	US
Telephone Number	:	507-251-2441
Fax Number	:

Provider Business Practice Location Address
First Line	:	3269 19TH ST NW
Second Line	:
City	:	ROCHESTER
State	:	MN
Zip	:	55901-7052
Country	:	US
Telephone Number	:	507-251-2441
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2017
Last Update Date	:	10/22/2025

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