MEDICARE: BRANDI KUYKENDALL

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	101YM0800X	Mental Health Counselor	37AC00864700	NJ

General Provider Information

NPI Number	:	1255127015
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDI KUYKENDALL

Provider Business Mailing Address
First Line	:	1701 PINEHURST EST
Second Line	:
City	:	LAKEHURST
State	:	NJ
Zip	:	08733-2418
Country	:	US
Telephone Number	:	518-859-0620
Fax Number	:

Provider Business Practice Location Address
First Line	:	1696 NJ-88
Second Line	:
City	:	BRICK TOWNSHIP
State	:	NJ
Zip	:	08724
Country	:	US
Telephone Number	:	732-561-8555
Fax Number	:

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

Provider Enumeration Date	:	04/17/2025
Last Update Date	:	04/17/2025

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Directions to “ BRANDI KUYKENDALL ” Practice Location

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