Individual
MS. KATHLEEN A. BRENCKLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
8500 BROOKTREE ROAD, SUITE 230, WEXFORD, PA 15090-9287
(724) 935-6922
(724) 935-6921
Mailing address
8500 BROOKTREE ROAD, SUITE 230, WEXFORD, PA 15090-9287
(724) 935-6922
(724) 935-6921
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
CW014480
PA
1041C0700X
Clinical Social Worker
Primary
CWO14480
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
204766131
TAX IDENTIFICATION NUMBER
PA
01
—
CW014480
LCSW - LICENSE NUMBER
PA
Enumeration date
02/26/2007
Last updated
07/26/2011
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