MEDICARE: DR. DARREN CHRISTOPHER BRENNAN PSYD

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	103TC0700X	Clinical Psychologist	0810005104	VA

General Provider Information

NPI Number	:	1770666000
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DARREN CHRISTOPHER BRENNAN PSYD

Provider Business Mailing Address
First Line	:	1801 ROBERT FULTON DR STE 230
Second Line	:
City	:	RESTON
State	:	VA
Zip	:	20191-5461
Country	:	US
Telephone Number	:	703-391-9410
Fax Number	:	703-476-7634

Provider Business Practice Location Address
First Line	:	1801 ROBERT FULTON DR STE 230
Second Line	:
City	:	RESTON
State	:	VA
Zip	:	20191-5461
Country	:	US
Telephone Number	:	703-391-9410
Fax Number	:	703-476-7634

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

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	11/27/2023

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