MEDICARE: BRENDA LEIGH ROULET LICSW

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	1041C0700X	Clinical Social Worker	SWI.LW.61661139	WA

General Provider Information

NPI Number	:	1548112113
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDA LEIGH ROULET LICSW

Provider Business Mailing Address
First Line	:	PO BOX 2832
Second Line	:
City	:	BATTLE GROUND
State	:	WA
Zip	:	98604-2905
Country	:	US
Telephone Number	:	503-707-6829
Fax Number	:

Provider Business Practice Location Address
First Line	:	PO BOX 2832
Second Line	:
City	:	BATTLE GROUND
State	:	WA
Zip	:	98604-2905
Country	:	US
Telephone Number	:	503-707-6829
Fax Number	:

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

Provider Enumeration Date	:	02/13/2026
Last Update Date	:	02/13/2026

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Directions to “ BRENDA LEIGH ROULET LICSW” Practice Location

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