Individual
GEORGE B BRENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
5470 E 16TH STREET, INDIANAPOLIS, IN 46218-4861
(317) 355-5009
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34002846A
IN
106H00000X
Marriage & Family Therapist
35000397A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000386704
ANTHEM-GALLAHUE MENTAL HEALTH SERVICES
IN
05
—
100270530A
—
IN
Enumeration date
04/18/2006
Last updated
10/22/2021
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