MEDICARE: DEBRA BRANDT

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	SW2761	FL
2	101YM0800X	Mental Health Counselor	SW2761	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982609277
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBRA BRANDT

Provider Business Mailing Address
First Line	:	PO BOX 731164
Second Line	:
City	:	ORMOND BEACH
State	:	FL
Zip	:	32173-1164
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	595 W GRANADA BLVD
Second Line	:	STE H
City	:	ORMOND BEACH
State	:	FL
Zip	:	32174-5182
Country	:	US
Telephone Number	:	386-673-9800
Fax Number	:	386-673-1111

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

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	09/11/2025

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Directions to “ DEBRA BRANDT ” Practice Location

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