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Individual

MS. ELIZABETH SPENCER BRENTJENS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
222 VIRGINIA RD # B, EDENTON, NC 27932-9667
(252) 506-1036
(252) 482-5910
Mailing address
218 COUNTRY CLUB DR, EDENTON, NC 27932-8904
(252) 506-1036
(252) 482-5910

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C004927
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
140E4
BCBSNC
NC
01
550068
VALUEOPTIONS
NC
05
6003739
NC
Enumeration date
01/13/2007
Last updated
07/08/2007
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