MEDICARE: MS. BRENDA EDWINA JAMES LMSW

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	011183	OH
2	104100000X	Social Worker	S0031365	OH
3	104100000X	Social Worker	S.2208208	OH

General Provider Information

NPI Number	:	1295866606
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BRENDA EDWINA JAMES LMSW

Provider Business Mailing Address
First Line	:	1815 W MARKET ST
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44313-7000
Country	:	US
Telephone Number	:	850-901-5654
Fax Number	:

Provider Business Practice Location Address
First Line	:	1815 W MARKET ST
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44313-7000
Country	:	US
Telephone Number	:	855-747-4673
Fax Number	:

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

Provider Enumeration Date	:	03/08/2007
Last Update Date	:	01/23/2024

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